REPORT 


ONiU  INSANE 


RD  OF  CHARITfES,   FROM  THE  OPERATIC 

OF  T"^     ^''  "  ■-■■-''-■'       '    ■ 


,*^%\Vt'»-# 


REPORT 


CHRONIC     INSANE 


IX    CERTAIN    COUNTIES,  EXEMPTED    BY    THE    STATE    BOARD 

OF  CHARITIES,  FROM  THE  OPERATION  OF  THE 

WILLARD  ASYLUM  ACT. 


By 

COMMISSIONERS  LETCHWORTH  AND  CARPENTER. 


TKAXSMITTED  TO    THE    LEGISLATURE    JANUARY    18,    18S2. 


ALBANY : 

WEED,  PARSONS  &  CO.,  PRINTERS. 
1882. 


^  y 


CONTENTS. 


Page. 

Preliminary  and  General. 

Institutions  Visited  and  Numbers  of  Inmates 1 

Condition  and  Habits  of  the  Insane 3 

Violent  and  Disturbed  Cases 4 

Epileptic,  Paralytic,  Suicidal  and  Homicidal  Cases 5 

Seclusion  and  Restraint.  .    6 

Kind  and  Extent  of  Mechanical  Restraint 7-8 

Cases  Treated  in  State  Asylums 8 

Dietary 9 

Classification 9 

Sane  Children 9 

Open  Fires  and  Ventilation 9 

Prescription  and  Case-Books 9 

Hospital  Accommodation 9 

Heating  and  Temperature 9 

Night  Watchmen 9 

Exercise  Yards 10 

Recreation  Grounds 10 

grames  and  entertainments .    .    10 

Rewards  for  Labor 10 

Water  Supply 10 

Sewerage; H 

Paying  Patients 1 1-12 

Cost  of  Maintenance 13 

Certificates  of  Commitment 13 

Acute  Cases 13 

The  Acute  Insane  of  Gtenesee  Co 13 

Medical  History  op  Transferred  Cases 13 

Unofficial  Visitation 13-14 

Curious  Strangers 14 

Paid  and  Pauper  Attendants. 14 

Buildings  and  Construction 14-15 

Notes  of  Yisitation. 

Broome  County 15-10 

Cattaraugus  (irUh  illustration,^  of  Cottage  plan) 19-24 

Chautauqua 24-31 

Chenango 32-36 

Cortland 36-42 

Erie  (with  illustrations  of  conf/yfi//ate  i>lan). 42-48 

Genesee 48-54 

Jefferson 54-58 

Livingston 59-65 

Oneida 65-69 

OnO'SDaga 69-73 

Orange.. 73-78 

Oswego 78-84 

Queens 84-89 

Suffolk 89-94 

Wyoming 94-98 

Conclusions  of  Commiitee 98-100 


Supplement.  I'age. 

Form  of  Medical  History  (Chautauqua  County) ^^*^~lni 

Rules  and  Regulations  (Erie  County) 1|^1 

Rules  and  Regulations  (Oneida  County)   ^"*^~}^2 

Dietary  (Orange  County) J"^ 

Dietary  (Queens  County) lUo-  iUJ5 


REPORT. 


To  the  state  Board  of  Charities  : 

At  a  stated  meeting  of  the  Board  held  at  Albany,  May  11,  1881 , 
a  committee  consisting  of  Commissioners  Letchworth,  Devereux, 
and  Carpenter,  was  appointed  to  visit  and  make  report  upon  the 
condition  of  the  insane  department  of  poor-liouses,  in  counties  ex- 
em^Hed  by  the  Board  under  chapter  713  of  the  Laws  of  1871,  from  the 
statute  requiring  the  chronic  insane  to  be  transferred  to  the  Willard 
Asylum.  Commissioner  Devereux  gave  early  notice  that  he  should  be 
unable  to  serve. 

The  counties  of  Cattaraugus  and  Livingston  having  applied  for 
like  exemptions,  upon  which  action  of  the  Board  is  now  pending,  the 
committee  extended  their  examination  to  the  insane  departments  of 
these  counties,  and  the  information  collected  in  regard  to  these  insti- 
tutions is  included  in  this  report. 

The  following  table  shows  the  counties  visited,  the  post-office  ad- 
dress of  the  institution,  and  the  date  of  inspection,  with  the  number 
of  inmates. 


I'oBt-ofiQce  Address. 

Date  of  Examination. 

Number  of  Insane. 

Total. 

M. 

F. 

Broome 

Cattaraugus.. 
Chautauqua. . 
Chenango..  . . 

Cortland 

Erie 

Binghamton . . 

Machias 

Dewittville  . . . 

Preston 

Cortland 

Buffalo  Plains. 

Linden 

Watertown  . .  . 

Geneseo 

Rome 

October  13,  1881 
August   12,     " 
Sept.          7,     " 
Nov.         4,     " 
October    4,     " 
Sept.        9,     " 
Sept.       19,     " 
October  13,     " 
Sept.      20,     " 
Sept.       26,     " 
October    5,     " 
Sept.       12,     " 
October    4,     " 
August     3,     " 
August  25,     " 
Sept.         5,     " 

72 
41 

81 
41 
29 

256 
25 
46 
57 

217 

106 
85 
56 

103 
50 
21 

35 
19 
39 
14 
14 
111 
14 
7 
24 
80 
73 
43 
18 
51 
28 
11 

37 
22 

42 

27 

15 

145 

Genesee 

Jefferson 

Livingston . . . 
Oneida 

11 
39 
33 
137 
33 
42 
38 
52 
22 
10 

Onondaga..  . . 

Orange 

Oswego 

Queens 

Suffolk 

Wyoming 

Onondaga  Hill 
Orange  Farm. 

Mexico 

Mineola 

Yaphank 

Varysburg .... 

1,286 

581 

705 

2  Report  on  the  Chroxjc  Insaxe. 

From  the  foregoing  table  it  will  be  observed,  that  the  total  number  of 
insane  in  the  sixteen  counties  visited  at  the  date  of  inspection  was 
twelve  hundred  and  eighty-six  (1,280),  of  whom  live  hundred  and 
eighty-one  (581)  were  men,  and  seven  hundred  and  five  (705)  were 
women. 

Some  of  the  institutions  were  visited  several  times,  the  examination 
occupying  one  or  more  days.  With  a  view  to  ascertaining  more  satis- 
factorily the  ordinary  condition  and  daily  routine  of  an  institution, 
no  intimation  of  the  intended  visit  was  in  any  instance  given. 

In  all  places  visited  by  the  Commissioners,  every  facility  to  complete 
the  examination  and  inspection  of  institutions  was  cheerfully  extended 
by  the  oHicials  in  charge,  and  it  is  believed  that  nothing  was  withheld 
from  observation. 

Where  the  county  physician  did  not  reside  at  the  poor-house,  he 
was  notified  upon  the  arrival  of  the  Commissioner,  and  such  informa- 
tion was  sought  from  him  as  related  to  his  particular  duties. 

The  committee  have  endeavored  to  make  their  inquiries  thorough, 
and  while  availing  themselves  of  such  accessory  helps  as  offered,  have 
placed  main  dependence  on  their  own  careful  personal  inspections. 

In  all  the  counties  except  Queens,  the  insane  department  is  an  in- 
tegral part  of  the  poor-house  establishment,  embraced  in  the  same 
financial  system  and  under  the  dii'ect  control  of  the  county  superin- 
tendents of  the  poor.  In  some  counties  the  buildings  for  the  insane 
are  separated  fr<:>m  the  poor-house  proper ;  in  others  they  are  connected. 
In  Queens  county  the  insane  are  cared  for  in  an  asylum  at  Mineola, 
under  the  charge  of  a  resident  superintendent,  the  poor-house  being  on 
Barnum  island,  some  ten  miles  distant. 

Such  facts  as  the  committee  found  susceptible  of  tabulation  have 
been  so  arranged,  and  are  presented  in  this  condensed  form  to  facili- 
tate comparison. 

The  following  table,  framed  from  the  statements  of  supervising  offi- 
cials, shows  the  condition  and  habits  of  the  insane  at  the  date  of  ex- 
amination : 


Report  on  the  Chronic  Insane. 


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4  Report  ox  the  Chronic  Insane. 

It  will  be  seen  that  five  hundred  and  sixty-five  (565)  were  classed  as 
continuously  quiet  ;  two  hundred  and  thirty-one  (231)  us  beiucj  sub- 
ject to  paroxysms  of  excitement ;  forty-four  (44)  as  continuously  vio- 
lent;  ninety-five  (05)  asdestructive  of  their  clothing,and  one  hundred 
and  sixty-two  (162)  as  filthy  in  their  habits.  The  committee,  however, 
are  not  prepared  to  verify  the  correctness  of  the  classification  as  to  the 
quiet,  excited  and  violent  cases,  especially  as  in  some  counties,  the 
lack  of  a  sufficient  number  of  attendants,  prevented  the  acquirement 
of  exact  knowledge  in  regard  to  the  varying  conditions  of  the  patients. 

It  appears  from  the  examination  that  the  number  of  continuously, 
violent  and  disturbed  cases  is  not  large.  The  presence  of  but  a  few  of 
this  class,  however,  in  the  small  institutions,  exerts  a  disturbing  in- 
fluence and  creates  disorder  and  confusion  in  what  would  otherwise  be 
an  orderly  and  pleasing  department,  while  adding  largely  to  the  ex- 
pense of  administration. 

It  is  therefore  desirable,  both  in  the  interest  of  the  insane  and  from 
an  economic  view  of  the  subject,  that  such  cases  should  be  removed 
to  ap]iropriate  State  institutions,  properly  equipped  for  the  special 
care  of  this  difficult  class. 

The  information  in  regard  to  epileptics,  paralytics,  suicidal  and 
homicidal  cases,  obtained  in  consultation  with  the  resident  officers 
and  county  physicians  is  tabulated  below. 


Keport  on  the  Chronic  Insane. 


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6  liEPOKT   OX    THE    ChRONIC    INSANE. 

The  foregoing  shows  that  there  were  in  the  institutions  examined 
seventy-seven  (77)  with  epileptic  and  twenty-four  (24)  with  paralytic 
complications,  fourtt-en  (14)  suicidal,  and  thirteen  (13)  homicidal  cases. 

The  number  found  confined  by  locking  in  cells  or  rooms  was  small 
—  in  no  county  exceeding  two,  even  these  being  excejitional.  None 
were  found  in  dungeons  or  dark  rooms.  In  two  of  the  counties  a 
"  restraint-book  "  was  kept,  in  which  were  recorded  the  time,  kind 
and  duration  of  the  restraint  enforced.  In  some  of  these  the  entry 
was  made  wckly,  the  attendants  meanwhile,  making  memoranda  on 
slips  of  paper  carried  in  their  pockets  and  handed  to  the  head  of  the 
department  at  the  end  of  the  week. 

The  extent  to  which  mechanical  restraint  is  resorted  to  is  shown  by 
the  following  table,  as  also  the  number  in  restraint  by  mechanical  ap- 
pliances on  the  date  of  visitation. 


Report  on"  the  Chronic  Insane. 


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Report  on  the  Chronic  Insane. 


The  number  of  cribs  belonging  to  tliese  institutions  was  thirty-nine 
(39),  the  number  of  restraining  chairs  thirty  (3(J),  of  muffs  forty-eight 
(48),  of  camisoles  forty-three  (43),  of  pairs  of  handcuffs,  thirty  (30),  of 
pairs  of  shackles,  eight  (8),  and  tlie  number  of  wristlet-bands  and 
waist-belts,  forty-six  (46).  The  committee  found  that, upon  the  date 
of  visitation  but  three  of  the  insane,  all  women,  were  actually  confined 
in  cribs  during  the  day,  and  that  the  number  restrained  in  chairs,  by 
muffs  and  otherwise,  was  thirty-four  (34),  twenty-three  ("^3)  men  and 
eleven  (11)  women. 

While  it  appears  from  the  examination  that  few  of  the  insane  were 
under  restraint,  the  presence  of  so  large  a  number  of  restraining  ap- 
pliances within  the  institutions,  in  the  absence  of  strict  rules  and 
regulations  on  the  subject,  may  lead  to  great  abuses.  Attendants  find 
it  much  easier  to  manage  and  control  excited  and  violent  patients,  for 
the  time  being,  by  })hicing  them  in  restraint,  rather  than  by  seeking  to 
overcome  their  violence  and  excitement  by  personal  attention  in  the 
wards.  This  mode  of  dealing  with  them,  is  quite  likely  to  be  resorted 
to  during  the  night  to  secure  the  ease  and  comfort  of  the  attendant, 
when  not  under  the  watchful  supervision  of  the  physician  or  other 
proper  officer.  It  is  regarded  best,  therefore,  to  discourage  the  em- 
ployment of  mechanical  restraint  in  the  care  of  this  class  of  insane, 
and  to  suggest  that  it  should  only  be  resorted  to  by  order  of  the  proper 
medical  officer,  and  that  a  careful  record  be  kept  of  its  kind  and  dura- 
tion. 

Information  as  to  the  number  who  had  received  treatment  in  State 
asylums  was  sought,  and  so  far  as  it  could  be  obtained,  is  set  forth  in 
the  following  table.  In  some  cases,  however,  the  figures  could  only 
be  approximatelv  reached,  owing  to  defective  records  ;  while  in  othera, 
no  registry  whatever  of  this  fact  being  kept,  even  approximate  esti- 
mates could  not  bo  reported. 


counties. 


Broome 

Cattaraugus. 
Chautauqua. 
Chenango . . 
Cortland.. . . 

Erie 

Genesee. . . . 
Jefferson .  . 
Livingston .. 
Oneida.  . . . 
Onondaga.  . 

Orange 

Oswego .... 

Queens 

Suffolk 

Wyoming. ., 


Number  treated  In  State 
asylums. 


Total.        Males.      Females. 


60 
37 

54 

"l5 

'"4 

8 

19 

192 

*73 

Go 
42 


17 
27 

io 

'3 
'9 


33 

25 

2 


20 

27 

"5 

1 

8 
10 


32 

17 

6 


Number  never  treated  in  State 
asylums. 


Total. 


11 

4 

27 

14 

21 
38 
38 
25 


38 

8 

13 


Males. 


11 

7 
15 


Females. 

3 

2 

15 

io 

-i 

10  « 
31d 
23 

J 

""'   '5 
4 


Report  on  the  CnROisric  Insane.  9 

With  the  exception  of  Queens  and  Orange  counties,  the  committee 
fonnd  no  printed  dietary.  In  Queens,  the  superintendent  has  in  use 
an  elaborate  and  somewhat  lengthy  schedule,  embracing  such  variety 
of  food,  as  in  his  opinion,  is  suffici'ent  to  secure  the  best  hygienic  re- 
sults.— A  copy  of  each  dietary  will  be  found  appended.  As  a  rule  it  was 
ascertained  that,  while  the  county  physician  had  a  general  knowledge 
of  the  kind  of  food  supplied,  it  was  not  regulated  by  him,  except  in 
one  or  two  instances.  The  diet  for  the  sick  was  prescribed  by  him, 
and  this  in  many  instances  was  supplied  from  the  keeper's  table. 

Owing  to  the  limited  number  of  insane  in  most  of  the  institutions, 
the  classification  observed  in  larger  establishments  is  not  effected,  a,l- 
though  carried  out  generally,  so  far  as  practicable,  by  the  officials  in 
charge.  Idiots  are  generally  separately  provided  for,  but  in  some 
instances  they  are  placed  in  the  insane  department. 

In  none  of  the  counties  were  sane  children  found  with  the  insane 
adults  except  Onondaga,  where  a  depraved  girl  under  sixteen  years  of 
age,  was  placed  in  the  insane  department  to  prevent  her  running  away. 
At  the  time  of  inspection  she  was  in  the  women's  work-room,  engaged 
in  sewing  with  the  other  inmates. 

The  committee  found  no  open  fires  in  any  of  the  rooms  occupied 
by  the  sick,  except  in  the  small  separate  hospital,  recently  erected  at 
the  Cattaraugus  county  poor-house,  in  which  it  was  stated,  open  fires 
were  to  be  kept  in  both  the  men's  and  women's  wards.  The  desira- 
bility of  open  fires  as  a  means  of  ventilation  in  apartments  for  the 
sick,"^  cannot  be  overestimated,  and  the  committee  regret  to  find  their 
absence  so  universal. 

In  two  of  the  counties  only  was  it  found  that  a  "  prescription 
book"  was  kept  in  the  insane  department,  and  in  but  two  counties  a 
"case  book"  setting  forth  the  condition  of  the  insane  from  time  to 
time.  The  necessity  of  preserving  a  record  of  all  prescriptions  given, 
and  the  importance  of  keeping  a  case  book  as  an  aid  to  successors  in 
office,  and  the  proper  treatment  of  each  patient,  are  manifest. 

In  a  few  of  the  counties,  there  is  a  hospital  ward  in  the  insane  de- 
partment, but  generally  the  insane,  when  sick,  are  either  treated  in 
their  sleeping-rooms  or  in  the  hospital  ward  of  the  main  poor-house, 
more  frequently  the  former.  The  presence  of  the  insane  in  the  com- 
mon hospital  ward,  is  always  a  source  of  annoyance  to  other  patients, 
hence  the  necessity  of  providing  hospital-rooms  for  the  separate  care 
of  the  insane  when  sick. 

In  some  of  the  counties,  thermometers  were  found  in  the  several 
wards,  but  in  no  instance  was  a  record  of  the  temperature  kept.  The  im- 
perfect plans  upon  which  many  of  the  buildings  are  constructed,  and 
the  varied  means  of  heating,  make  it  questionable  whether  in  all  cases 
there  is  a  sufficient  degree  of  warmth  throughout  the  buildings,  es- 
pecially as  the  vital  forces  of  the  insane  are  below  the  normal  condi- 
tion, and  they  therefore  require  a  higher  temperature  than  sane  per- 
sons generally.  It,  therefore,  seems  desirable  that  a  record  of  tempera- 
ture should  be  kept,  not  only  for  the  satisfaction  of  friends  of  patients 
and  the  information  of  supervising  officials,  but  as  a  protection  to  those 
in  immediate  charge. 

In  several  of  the  larger  institutions,  a  wise  precaution  is  taken  in 
the  employment  of  a  night-watchman,  as   a  better  protection  against 


10  Report  on  the  Chronic  Insane. 

fire.  He  is  also  charged  with  the  duty  of  arousing  attendants  in  cases 
of  emergency. 

In  nearly  all  the  counties,  there  are  connected  with  the  insane  de- 
partments, separate  yards  for  the  men  and  women,  in  which  they  are 
permitted  to  exercise.  The  yards  are  generally  quite  small.  The 
measurements  will  be  found  in  the  notes  of  visitation  embodied  herein. 
These  yards,  however,  are  surrounded  by  close  board  fences  from  ten  to 
fourteen  feet  high,  except  in  two  counties  where  pickets  are  used.  The 
prospect  of  the  surrounding  country,  and  free  air  are  obstructed,  while 
the  lieated  atmosphere  in  the  summer  is  quite  oppressive. 

The  committee  found  that  almost  without  exception,  the  doors 
opening  into  these  yards  from  the  wards  were  unfastened,  thus  af- 
fording the  advantage  of  free  communication.  In  several  institutions 
this  freedom  was  extended  to  the  kitchen,  dining,  and  other  depart- 
ments of  the  house,  and  in  one  instance,  a  low  picket  fence  formed  the 
sole  barrier  to  the  use  of  the  poor-house  grounds.  The  number  even 
thus  restricted  was  comparatively  few,  while  in  Cattaraugus  county, 
the  insane  occupy  cottages  with  unlocked  doors,  and,  under  the  su- 
pervision of  attendants,  enjoy  the  full  liberty  of  surrounding  grounds, 
the  few  violent  cases  being  restricted  to  the  main  poor-house  and 
permitted  recreation  in  its  adjacent  yard.  In  Oneida  county  the  in- 
sane are  taken  to  walk  upon  the  roads,  and  in  Suffolk  and  Orange 
counties,  they  stroll  about  the  farm  arid  groves  in  charge  of  their  attend- 
ants. With  these  exceptions,  there  were  no  grounds  aside  from  the 
yards  appropriated  for  the  recreation  of  the  insane. 

Confinement  in  these  small  yards  must  be  irksome  to  patients,  and 
tends  to  increase  restiveness  and  discontent.  It  having  been  demon- 
strated in  some  asylums  that  these  yards  are  unnecessary,  it  would  seem 
that  if  the  continuously  violent  and  disturbed  patients  were  removed 
to  appropriate  State  asylums,  and  a  reasonable  number  of  paid  attend- 
ants employed,  that  these  barriers  might  be  removed  altogether. 
Exercise  and  recreation  might  be  effected  in  open  grounds  set  apart 
for  the  purpose,  as  w'ell  as  along  the  country  roads  and  in  the  neigh- 
boring woods. 

In  the  way  of  out-door  recreations  and  amusements.  Orange  and 
Livingston  counties  provide  swings  for  both  men  and  women,  and  in 
the  latter  count}',  quoits  are  also  furnished  to  the  men.  Broome  and 
Erie  counties  permit  patients  to  "play  ball."  With  these  exceptions, 
no  out-door  amusements  a"e  provided  for  either  sex.  In  the  two 
counties  first  named  and  in  Oneida,  entertainments  of  music  and 
dancing  are  occasionally  provided.  Reading  matter  is  generally  sup- 
plied. In  nearly  all  the  counties,  means  to  play  checkers,  dominoes 
and  other  games  are  furnished  to  the  men. 

In  a  few  instances,  it  was  observed  that  the  custom  prevailed  of 
granting  some  trivial  favor  or  luxury  to  the  insane,  as  a  reward  for 
their  labor.  The  testimony  of  officers  on  this  point,  shows  that  the 
practice  stimulated  industrious  habits  and  good  behavior. 

In  many  of  the  institutions  visited,  the  water  supply  was  found  in- 
adequate, not  only  to  meet  sanitary  needs,  but  as  a  protection  against 
fire  ;  especially  was  this  found  to  be  the  case  in  the  counties  of  Erie, 
Livingston  and  Cattaraugus,  Except  by  those  immediately  con- 
nected with  the  institutions,  the  necessity  for  copious  supplies  of  pure 
water  does  not  seem,  generally,  fully  to  be  appreciated. 


Report  on  the  Chronic  Insane.  11 

The  system  of  sewerage  in  several  institutions  was  found  defective, 
and  the  closets,  owing  either  to  a  lack  of  water  or  imperfect  construc- 
tion, were  frequently  offensive. 

in  many  of  the  counties,  a  considerable  income  is  derived  from  the 
friends  or  relatives  of  the  insane  ;  the  charges,  always  moderate,  being 
usually  regulated  according  to  the  ability  of  the  parties  to  pay.  The 
following  table  exhibits  information  on  this  subject,  so  far  as  obtain- 
able. 


12 


Report  on  the  Chronic  Insane. 


-  i  •  «« 

X 


00»OO»OOOiOOOOOOOOCO 

o  -o  >c  T<  •--  .— I  r^  <-  o  c-  -^r  tc  :c  o  to  o 
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«*         ^     ^  ^  ^ 

.-I  ^  lO  .-.  T^ 


CO 
CO 


o 

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« t^  u  2 

32  c  =  5  3 
„  c  o  o  >r> 

lllllll 


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O 


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—  lO 


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O  •  CO 


o 

00 

00 
4» 


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30  lO  O  »0  O 

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CO  '*  X  i-i  CO 


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>-'OCO'<4<OOCOOOO 

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i>cooci'^s^j«*05^eo 


o 
o 
o 

I— I 
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s 


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54. 


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Po  "  -^  "S 


Eepokt  on  the  CHfioNic  Insane.  13 

It  is  evident  that  in  some  counties,  the  importance  of  preserving  the 
interest  of  relatives  in  their  insane  kindred,  by  requiring  them  when 
ible  to  contribute  to  their  support,  does  not  receive  sufficient  attention 
it  the  hands  of  the  officials,  and,  as  a  result,  the  patients  suffer  from  the 
withdrawal  of  sympathy  and  the  county  loses  pecuniarily.  It  may  be 
regarded  as  sound  policy  to  require  payment  in  part  at  least,  in  all 
3ases  where  friends  or  relatives  are  able  to  do  so  ;  but  this  should  not 
be  exacted  to  an  extent  to  endanger  the  conti'ibu tor's  capacity  for  self- 
upport.  Where  relatives  or  friends  continue  to  support  insane  kin- 
dred, their  self-respect  is  preserved  and  the  family  interest  maintained. 
Owing  to  the  fact  that  the  accounts  of  the  chronic  insane,  are  mer- 
ged in  those  for  maintenance  of  ordinary  paupers,  it  was  not  practica- 
ble to  arrive  at  the  cost  of  their  support.  In  the  county  of  Queens, 
where,  as  has  been  stated,  the  insane  department  is  entirely  separate 
from  the  poor-house  administration,  the  cost  is  given  in  round  numbers 
as  $3.50  per  week.  This,  however,  is  much  reduced  by  the  income 
derived  from  private  patients,  many  of  whom  are  received  from  without 
the  county.  In  Erie  county  during  the  last  year,  the  accounts  for  main- 
taining the  insane  were  kept  separately,  and  the  cost  is  reported  as  $2.58 
per  week  per  capita.  In  neither  of  these  counties  is  the  investment  in 
buildings  taken  into  consideration. 

The  examination  developed  the  fact  that  in  some  instances,  cases  of 
acute  insanity  had  been  retained  in  the  county  establishments  contrary 
to  law.  In  several  of  the  cases  which  were  examined  into,  it  appeared 
that  the  county  physician  was  ignorant  of  the  fact,  as  Avere  also  the 
snperintendents  of  the  poor.  It  frequently  happens  that  the  certificates 
af  insanity  are  meagre  and  vague,  and  the  officers  to  whose  custody 
the  patient  is  committed  are  unable  to  determine  the  duration  of  in- 
sanity, or  to  obtain  otlier  knowledge  necessary  to  a  proper  disposal  or 
treatment  of  the  case.  It  would  seem  that  the  papers  committing  the 
pauper  insane  to  county  poor-houses,  should  in  all  cases  clearly  set  forth 
3uch  facts  as  would  determine  the  duration  of  insanity,  and  that  the 
ounty  judge  having  the  evidence  before  him,  should  remove  any  doubt 
upon  this  point. 

It  appears  that  Genesee  county  is  exempt  by  law,  from  the  general 
statute  requiring.the  acute  insane  to  be  sent  to  State  hospitals  for 
treatment.  The  examination  shows,  that  this  county  possesses  no  con- 
veniences in  the  way  of  buildings,  attendants,  medical.'oversight,  and 
3ther  essentials  for  the  treatment  of  this  class,  above  those  of  poor- 
houses  generally  ;  indeed  it  is  in  many  respects  greatly  inferior  to  the 
average  of  this  class  of  institutions.  It  is,  therefore,  believed  that  this 
special  legislative  privilege  should  be  revoked,  and  the  county  brought 
under  the  same  obligations  and  requirements  as  other  counties  in  re- 
gard to  the  acute  insane. 

In  a  number  of  instances  the  physicians  expressed  the  opinion,  that 
as  an  aid  to  proper  treatment,  patients  when  returned  from  the  State 
asylum,  should  have  forwarded  with  them  a  record  of  their  medical 
history,  with  a  statement  of  the  peculiarities  of  their  case  while  in  the 
State  institution. 

Most  of  the  county  institutions  it  was  found,  were  occasionally  visited 
by  public-spirited  and  influential  citizens,  and  sometimes  physicians 
in  the  county,  manifested  an  interest  by  calling;  but  these  occasions 
were  rare,  such  visits  on  the  part  of  medical  men  being  for  the  most 


14  Report  on  the  Chronic  Insane. 

part  inspired  by  an  interest  in   those  who  had  been  former  patients  of 
the  visitors. 

It  is  customary  for  the  board  of  supervisors  during  its  annual  ses- 
sion, to  make  an  inspection  of  the  county  poor-house  when  in  its  best 
condition.  This  inspection,  generally  hurried  and  superficial,  creates 
a  favorable  opinion  of  the  institution.  It  is  but  natural  that  the 
impression  made  on  the  minds  of  the  local  representatives  of  the  peo- 
ple, should  be  reflected  in  the  press  of  the  county.  The  event  of 
the  season  being  over,  the  institution  may  lapse  into  a  different  routine, 
and  the  apathy  of  those  who  should  manifest  a  continued  interest,  is 
as  discouraging  to  the  officials  in  charge,  as  is  an  appreciative  interest, 
stimulating  to  faithful,  vigilant  and  steady  effort.  Especially  does 
this  seem  to  be  the  case  in  remote  places.  It  is  therefore  evident,  that 
unofficial  visits  from  public-spirited  citizens  and  local  committees, 
extending  through  all  the  seasons  of  the  year,  must  be  attended  with 
highly  beneficial  results. 

In  nearlv  all  the  counties  complaint  was  made  of  annoyance, 
occasioned  by  visits  from  pleasure  seekers  and  those  who  were  prompted 
only  by  motives  of  idle  curiosity.  In  some  of  the  counties  this  custom 
had  grown  to  the  magnitude  of  an  abuse,  through  which  the  quiet  of 
the  patients  and  the  orderly  management  of  the  establishment  were 
interrupted. 

While  these  institutions  should  at  all  times  be  open  to  inspection, 
thev  ought  not  to  be  made  places  of  idle  resort,  and  the  insane  exhibited 
as  a  siiectacle  for  the  curious.  It  would  seem  proper,  therefore,  that 
the  visits  of  interested  persons  should  be  regulated  by  the  physicians 
in  charge. 

The  number  of  paid  attendants  in  charge  of  the  insane,  as  will  be 
seen  by  the  notes  of  visitation,  in  some  counties  is  greatly  deficient. 
This  is  especially  the  case  in  Chautauqua  county,  where,  as  an  inevitable 
consequence,  a  deplorable  condition  exists.  The  tendency  of  all  insane, 
when  without  adequate  supervision,  is  to  degenerate.  If  under  in- 
telligent management,  they  may  generally  be  controlled  and  guided 
into  habits  of  neatness  and  order  and  may  frequently  be  trained  to 
healthful  and  productive  industry.  The  efforts  to  economize  by 
placing  the  insane  under  paupers,  or  the  failure  to  provide  suitable 
attendants,  in  the  end  usually  proves  expensive,  for  the  reason  that, 
from  being  useful  and  productive,  or  even  quiet,  they  become  violent 
and  destructive  and  thus  expensive. 

A  serious  disregard  of  an  essential  principle  of  supervision  appears 
from  the  notes  of  visitation.  In  two  of  the  counties  on  arrival  at  the 
institutions,  the  insane  departments  were  found  locked.  Those  "in 
charge  "  were  absent  and  had  taken  the  keys  with  them,  leaving  the 
insane  without  the  supervising  care  of  either  paid  or  pauper  attendant?. 
Such    neglect,  inviting    the  most  serious  consequences,  is  inexcusable. 

What  information  the  committee  could  not  readily  generalize  or 
tabulatCjWill  be  found  in  the  notes  of  visitation  incorporated  herewith, 
embracing  the  location  and  sanitary  surroundings  of  the  buildings, 
internal  subdivision  and  apportionment  of  rooms,  methods  of  heating, 
ventilation  and  lighting,  house-keeping  and  domestic  arrangements, 
dormitory  and  Ijahiing  facilities,  food,  clothing  and  general  care  of  the 
inmates,  etc. 

In  but  few  of  the  counties,  have  the  plans  of  the  building  occupied 


Report  on  the  Chronic  Insane.  15 

by  the  insane,  been  submitted  to  experts  before  erection.  Tlic  Orange, 
Erie  and  Cattarangns  county  buildings  are  exceptions.  The  two  last 
named  are  outlined  in  the  accompanying  notes  of  visitation.  The 
plans  for  these  three  counties  were  approved  by  the  Board,  and  the 
buildings  afterward  constructed,  with  slight  deviations,  on  the  plans 
as  approved.  As  a  consequence,  there  is  a  marked  contrast  in  the  two 
classes  of  structures.  In  the  first  are  many  serious  defects,  among 
which  may  be  noted  the  following:  A  general  prison-like  character  of 
exterior,  which  with  their  strongly  barred  and  grated  windows,  and 
yards  surrounded  by  high  plank  fences,  betoken  to  the  passing  observer 
a  jail  rather  than  an  asylum  for  the  insane.  Their  interiors,  with 
iron  gratings,  screened  windows,  studded  doors  and  heavy  bars  and 
padlocks,  suggest  a,t  once  force  dnd  resufcuice  ;  sleeping-rooms  some- 
times exceedingly  small,  absence  of  light,  narrow,  steep  and  crooked 
stairways,  dark  halls,  small  and  dimly-lighted  or  even  dark  rooms  for 
storing  clothes  or  linen,  imperfect  ventilation,  improperly  constructed 
water-closets,  defective  sewerage,  and  a  faulty  general  arrangement, 
obstructing  economical  administration  and  complete  supervision. 

It  is,  therefore,  evident  that  economy  and  more  satisfactory  results 
every  way  will  be  reached,  by  requiring  in  the  future,  that  the  plans 
of  buildings  for  the  care  of  the  chronic  insane,  be  submitted  to  and 
approved  by  competent  authority,  before  contracts  are  made  for  their 
erection. 

NOTES  OF  VISITATION. 

Broome  County. 

The  county  of  Broome  was  in  1877  exempted  by  the  State  Board  of 
Charities  from  the  operation  of  the  Willard  Asylum  Act,  and  sub- 
sequently had  maintained  its  chronic  insane  at  the  poor-house,  which 
is  located  in  the  town  of  Binghamton,  upon  the  county  farm  of  130 
acres,  three  miles  from  the  city  of  Binghamton. 

The  department  of  the  poor-house  assigned  to  the  insane,  is  under 
the  same  supervision  and  care,  as  that  provided  by  the  county  for  its 
sane  dependents.  The  persons  in  charge  are  the  county  superintend- 
ent of  the  poor,  the  resident  keeper  and  the  matron,  who  have  received 
from  the  superintendent  successive  annual  appointments  since  1879, 
and  whose  joint  salaries  amounted  the  past  year  to  $800. 

The  county  buildings  for  the  various  departments  of  the  poor-house, 
are  adapted  in  number  to  assist  in  the  classification  of  the  inmates, 
and  are  as  varied  in  size  as  in  their  use.  They  are  built  in  two  rows 
upon  the  opposite  sides  of.a  street  or  avenue,  upon  the  east  of  which 
are  the  principal  poor-house  buildings  for  the  sane  inmates.  The 
three  north  l)uildings  upon  the  west  side  of  the  street,  are  fitted  for 
and  occupied  as  the  department  of  the  insaije,  called  the  asylum. 

The  insane,  men  and  women,  each  occupy  a  two  story  and  basement 
wooden  building.  The  basements  under  each  building  are  used  for 
furnace,  coal,  storage,  bathing  and  washing-rooms,  but  not  for  storing 
vegetables. 

The  windows  in  the  insane  department,  have  spring  fastenings  and 
may  be  lowered  from  the  top.     The  glass  is  generally  protected  by  a 
wire  netting,  placed  inside  of  the  locked  wooden  gratings. 
3 


16  Report  on  the  Chronic  Insane. 

The  m.ain  building,  as  it  is  designated,  is  occupied  by  men,  and  has 
two  stories,  each  nine  feet  in  height.  The  four  wards  for  men  have 
thirty-one  single  rooms,  twenty-nine  of  which  are  eight  by  ten  feet 
(having  a  capacity  of  seven  hundred  and  twenty  cubic  feet  each) 
and  two  of  wliich  are  ten  by  twelve  feet,  and  one  associate  dormitory 
with  eight  beds.  The  rooms  are  separated  from  the  hall  (five  and  a 
half  feet  in  width)  by  slat  partitions  and  doors. 

The  north  two  story  wooden  building  is  occupied  by  insane  women, 
each  story  being  nine  and  a  half  feet  high.  The  three  wards  have 
twenty-one  single  rooms,  eight  by  ten  feet  each,  and  three  associate 
dormitories,  nineteen  by  twenty-one  feet  each,  and  each  with  eight 
beds.     Each  story  has  a  day  or  work-room  twenty  feet  square. 

The  doors  to  many  of  the  rooms  in  the  insane  department  are  of 
slats,  and  the  partitions  and  ceilings  of  narrow  matched  boards,  and 
tinted.  Good  results  have  been  obtained  by  tinting  the  rooms  aild 
using  colored  glass  for  some  of  the  windows.  There  are  no  lathed 
and  plastered  walls  in  the;  insane  department.  Duplicate  locks  can 
be  opened  by  one  pass-key.  The  day  or  work-room  for  the  women 
upon  the  first  story,  is  furnished  with  a  rag  carpet  (made  ready  for  the 
weaver  by  the  patients),  a  center  table  with  books  upon  it,  engravings 
hanging  upon  the  walls,  white  window  shades,  a  rocking  chair,  sewing 
machine  and  a  singing  bird,  etc.  Upon  the  day  of  my  visit,  two 
women  were  sewing  in  charge  of  an  attendant,  while  another  in  a 
paroxvsm  was  confined  by  a  muflf. 

The  day-room  of  the  same  size  in  the  second  story,  is  plainly 
furnished  with  wooden  chairs  and  benches.  The  halls  are  also  used 
as  sitting-rooms,  and  many  of  the  rooms  have  close  inner  doors  for 
day  use,  thus  keeping  the  air  in  the  rooms  fresh  for  the  night. 

The  buildings  arc  warmed  by  two  furnaces  in  the  cellar  of  the  men's 
and  three  in  that  of  the  women's  apartments.  There  are  registers  in 
the  halls,  dormitories  and  day-rooms.  Coal  is  burned  except  in  the 
dining-rooms  and  kitchen,  where  wood  is  used.  It  is  said  that  in  the 
past  the  heat  has  been  sufficient.  Thermometers  are  placed  in  the 
hospital  and  wards. 

Ventilation  is  secured  by  flues  in  the  floors,  and  by  pipes  to  the 
chimney.  In  the  disturbed  wards  the  communication  is  directly  to  the 
chimney.  Light  is  obtained  by  kerosene  lamps  suspended  from  the 
hall  ceilings.     There  is  no  hospital  for  the  insane  women. 

South  of  the  main  building  for  the  insane  men,  and  annexed  to  it 
by  a  hall  that  serves  as  the  office  and  dispensary,  is  the  men's  hospital. 
It  is  a  one-story  building  with  a  basement.  The  first  of  the  two  rooms 
is  seventeen  feet  square,and  is  used  asan  attendants'  sitting-room,  as  well 
as  a  day-room  for  convalescents.  Its  five  windows,  coal  stove,  carpeted 
floor  and  house  plants,  give  it  a  comfortable  appearance.  The  second 
room  is  the  hospital  for  insane  men.  It  is  twenty  feet  square  and  nine 
feet  high,  with  three  beds.  Several  chairs,  one  being  a  restraining 
chair  with  liead  rest  and  straps,  are  in  the  room.  It  is  warmed  by  a 
pipe  from  a  stove  in  the  "  poor-house  jail,"  in  the  basement,  and  by 
warm  air  from  the  front  room  through  a  slat  door.  The  hospital-room 
has  five  windows,  and  is  light  and  well  ventilated.    It  has  no  open  fires. 

The  insane  are  bathed  and  furnished  with  clean  clothing  eacli  Sat- 
urday. The  bathing  arrangements  in  the  basement  of  the  main  build- 
ing are  in  an  incomplete  state,  but  are  intended  to  be  similar  to  those 


Eeport  On  the  Chronic  Insane.  17 

in  use  in  the  women's  building,  namely,  a  tank  of  water  and  bath  tubs. 
Iron  sinks  with  hand  basins  are  provided  in  the  halls  for  daily  use. 

There  is  no  separate  laundry  for  the  insane.  The  washing  for  the  in- 
sane men,  is  done  one  day  each  week  in  the  poor-house  laundry.  The 
conveniences  of  tubs,  pounding  barrels  and  water  are  in  the  basement 
of  the  women's  building,  with  which  a  drying  yard  is  connected. 

Water  is  obtained  from  two  dug  wells,  two  driven  wells  and  a  spring, 
from  which  it  is  conveyed  in  iron  pipes  to  the  building.  The  waste 
water  runs  into  a  cistern  of  a  capacity  of  tsvo  hundred  barrels.  There 
is  a  cistern  of  one  hundred  barrels  capacity  at  the  men's  building,  one 
of  the  same  size  in  the  basement  of  the  keeper's  residence,  and  one  in 
each  of  the  buildings  for  the  insane.  The  supply  is  said  to  be  ample. 
Two  hundred  feet  of  hose  can  be  attached  to  a  force  pump  which,  with 
the  aid  of  three  men,  would  be  of  power  sufficient  to  throw  water  over 
any  part  of  the  buildings  in  case  of  lire.  The  stairways  and  doors  con- 
stitute the  fire-escapes. 

The  sewerage  consists  of  one  main  sewer,  "  to  which  every  thing  is 
carried,"  and  which  empties  into  a  swamp  two  hundred  feet  distant, 
and  thence  runs  into  the  Chenango  river.  At  the  west  of  each  airing 
court  is  a  closet,  that  is  said  to  be  cleaned  three  or  four  times  during 
a  season  and  each  time  filled  with  fresh  earth. 

Each  disturbed  ward  has  four  rooms,  two  of  which  were  occupied 
upon  the  day  of  my  visit,  by  men  who  were  violent  and  destructive  of 
clothing,  and  were  confined  to  insure  the  safety  of  others.  One  of  the 
two,  a  strong,  excited  man,  was  in  a  restraining  chair,  and  it  was  said 
would  be  removed  to  the  Binghamton  asylum  soon  ;  these  men  are  said 
to  be  out  daily  for  air  and  exercise. 

The  day-room  for  men,  is  between  the  disturbed  ward  and  the  en- 
trance hall  of  seventy-eight  feet  in  length.  It  is  about  twenty-five  feet 
square,  is  surrounded  by  benches,  and  has  a  door  leading  from  it 
into  an  exercise  yard  of  one  hundred  and  five  by  eighty  feet.  This  yard 
is  covered  with  grass  and  has  a  shed  with  benches  under  it.  The 
trees  are  too  small  to  afi'ord  shade.  The  exercise  yard  for  women  has 
a  shelter  in  the  center,  called  a  pagoda. 

A  paid  night-watchman  at  $15  per  month  is  on  duty,  from  dark 
until  relieved  in  the  morning. 

The  kitchen  is  in  the  basement  of  the  small  central  two-story  brick 
building,  midway  between  the  two  insane  departments.  It  is  sixteen  by 
twenty-three  feet  and  has  a  brick  floor,  four  windows,  a  stove  for  cook- 
ing and  warmth,  a  boiling  kettle  and  a  sink  for  washing  dishes. 
Water  is  heated  in  the  stove  reservoir.  The  bread  is  baked  in  the  brick 
oven  of  the  poor-house.  The  cook  for  the  insane  is  paid  two  dollars 
per  week  and  is  assisted  by  the  patients. 

The  dining-room  for  the  insane  men  is  twelve  by  thirty-eight  feet 
and  opens  from  the  kitchen.  When  not  in  use  as  a  dining  room,  it 
serves  for  an  ironing  room. 

At  the  time  of  my  visit  six  women  were  ironing,  supervised  by  an  at- 
tendant. The  women's  dining-room,  of  the  same  size,  upon  the  first 
story,  is  connected  by  a  covered  passage  with  the  women's  apartments. 
It  has  green  shades  at  the  six  windows,  each  dining-room  is  furnished 
with  pine  tables  and  stools,  white  table  cloths,  bowls  and  plates  of 
white  earthenware  and  knives  and  forks  of  steel.  The  bread  was  good. 
The  bill  of  fare  as  furnished  by  the  keeper  is  not  printed.    The  break- 


18  Report  ox  the  Chronic  Insane. 

fasts  of  each  day  are  alike  (except  that  coffee  is  given  three  times  a 
week)  and  consf^ts  of  boiled  potatoes,  cold  meat,  bread  and  butter, 
tea,  or  milk  lor  those  who  prefer  it. 

Monday—  Dinner,  potatoes,  fresh  beef,  bread  and  butter,  oat-meal 
or  rice,  tea ;  supper,  bread  and  butter,  sauce,  tea. 

Tuesday— Dinner,  vegetable  and  beef  soup,  rice  pudding;  supper, 
bread  and  milk. 

Wednesday  —  Dinner,  boiled  dinner  and  corn  bread  ;  supper,  bread 
and  butter,  sauce,  tea,  cake. 

Thursday —  Dinner,  corned  beef,  vegetables,  pie;  supper,  rice  and 
milk. 

Friday —  Dinner,  tish  and  vegetables,  bread  pudding  ;  supper,  bread 
and  butter,  sauce,  tea,  cookies. 

Saturday  — Dinner,  roast  beef,  vegetables,  graham  bread;  supper, 
mush  and  milk,  ginger  cake. 

iSundav —  Dinner,  beef  and  vegetables,  rice  pudding. 

Dr.  Richards  has  for  sixteen  years  had  the  medical  supervision  of 
the  institution,  receiving  his  appointment  from  the  supervisors,  and  a 
salary  of  $350  per  year,  for  which  he  makes  three  visits  each  week, 
and  more  if  cases  require  his  attention.  Assistants  invited  to  aid  in 
operations  and  consultations,  are  paid  by  the  county.  To  Dr.  Richards 
belongs  much  of  the  credit  of  the  evident  good  order  and  arrangement 
of  the  insane  department.  He  states  that  whenever  in  his  judgment, 
any  thing  has  seemed  necessary  to  add  to  the  comfort  of  his  patients, 
his  application  for  it  to  the  supervisors,  superintendent  or  keeper  has 
been  successful. 

He  prescribes  the  diet  and  it  is  prepared.  Restraint  is  reported  to 
him  by  the  attendants. 

Each  disturbed  ward,  has  a  light,  well-ventilated  strong-room.  Of 
the  three  cribs  in  the  institution,  but  one  is  in  use.  There  are  no  dark 
cells  or  dungeons.  There  are  four  strong  arm-restraining  chairs,  with 
straps  and  head-rests,  three  muffs,  three  pairs  of  handcuffs,  two  pairs 
of  iron   shackles,  and  three  waist  straps. 

No  restraint  book  is  kept.  The  attendants  place  patients  in  restraint, 
if  necessary,  during  paroxysms,  and  report  to  the  attending  physicians. 
Punishment  is  not  inflicted  upon  the  insane.  Prescription  and  case 
books  are  not  kept  in  the  institution.  Certificates  of  insanity  are  on 
file,  and  the  insane  are  registered  separately  from  the  sane. 

The  medicines  are  supplied  by  the  county  and  are  dispensed  by  the 
physician.     There  are  no  consulting  physicians. 

Members  of  the  medical  profession  and  citizens  of  the  county, "  mani- 
fest their  interest"  in  the  institution  by  visits. 

Separate  apartments  and  care  are  provided  for  insane  men  and 
women  in  the  buildings  and  exercise  yards,  but  elsewhere  the  separa- 
tion cannot  be  effe<-ted  except  by  watchful  supervision. 

The  insane  are  classified  by  the  pliysician  according  to  their  habits 
and  condition.  Epileptics  do  not  receive  special  care  ;  the  watchman 
attends  to  them  at  night  and  calls  the  attendants  if  necessary.  Idiotic 
adults,  and  idiotic,  epileptic  or  feeble-minded  children  are  cared  for  in 
other  departments  of  the  poor-house. 

Neither  in-door  nor  out-door  amusements  are  provided  for  either  men 
or  women   regularly,  and   there  are  none   in   which    both    men    and 


Report  ox  the  Chronic  Insane.  19 

women  join.     There  is  in  the  summer  season  an  occasional  game  of 
ball,  and  dominoes  and  checkers  are  provided. 

Four  daily  and  three  weekly  papers  are  taken  by  the  keeper,  and  the 
ladies,  and  bookstores  in  Binghamton,  furnish  reading  for  the  insane. 

The  insane  men  are  employed  in  the  cultivation  of  the  farm  and 
garden  under  the  supervision  of  a  farmer,  but  they  have  no  in-door  oc- 
cupation. Three  of  these  can  perform  a  fair  day's  labor  and  ten  a 
partial  one.  Insane  women  assist  in  the  cultivation  of  plants,  sew, 
knit,  iron,  wash  and  do  other  housework,  nine  can  perform  a  partial 
day's  work,  under  the  immediate  care  of  attendants. 

All  labor  is  supervised  and  directed  by  the  keeper,  who  judges  as  to 
the  amount  and  kind  to  be  assigned  to  each  patient. 

The  labor  of  the  insane  is  remunerative  in  so  far  as  it  takes  the 
place  of  hired  labor.  It  is  considered  one  of  the  most  beneficial  of  all 
influences  that  can  be  brought  to  bear  upon  the  minds   of   the  insane. 

The  insane  are  in  charge  of  the  keeper,  assisted  by  two  farmers  at 
$20  per  mouth,  one  at  §18,  and  two  female  attendants  who  receive 
respectively  §3   and  S2.50  per  week. 

Paupers  do  not  assist  in  the  care  of  the  insane.  The  keeper  has  the 
direction,  care  and  management  of  the  institution  and  of  the  eniployees. 

During  the  past  year  the  cost  per  capita  of  the  sane,  was  ninety-six 
cents  per  week,  that  of  the  insane  amounted  to  81.50  each  per  week, 
exclusive  of  the  products  of  the  farm  ;  the  vegetables  for  table  use  are 
raised  upon  the  farm. 

Upon  October  13,  1881,  the  date  of  inspection,  there  were  seventy- 
two  resident  insane,  of  whom  thirty-five  males  and  thirty-seven  females 
had  accommodations  in  the  asylum  department,  and  nine,  for  various 
reasons  were  assigned  to  places  in  the  poor-house  division  with  the  sane. 

Two  men  were  in  restraint  of  tlie  halls,  and  two  were  confined  to 
their  rooms.  Xone  were  in  dungeons,  dark  cells  or  cribs.  One 
woman  was  confined  by  a  mufE,  one  man  in  a  chair,  and  one  with 
hand-cuffs  in  the  exercise  yard. 

AH  have  been  treated  in  State  asylums  with  the  exception  of  eight 
men  and  three  women,  who  were  chronic  cases  of  insanity  when  re- 
ceived.    Xone  were  in  the  hospital  for  men. 

The  bedsteads  are  all  of  wood  with  iron  slats,  upon  which  were 
straw  beds,  sheets,  comfortables  or  quilts,  white  covers,  pillows  and 
cases.     The  whole  asylum  department  was  neat  and  in  good  order. 

Clothing  is  provided  by  the  county  for  all,  except  pay  patients,  and 
the  greater  portion  of  it  is  made  up  in  the  institution  by  hired  help. 
Coats  are  purchased  in  Binghamton.  Acute  cases  of  insanity,  are  only 
allowed  to  remain  while  papers  are  being  prepared  for  their  removal 
to  State  asylums. 

Pay  patients  are  received  from  Broome  and  other  counties  at  the 
rate  of  two  dollars  per  week. 

Visited  by  Commissioner  Carpenter  October  13,  1881. 

Cattaraugus  County. 
The  poor-house  of  this  county  is  situated  on  the  west  side  of  Lime 
Lake,  in  the  town  of  Machias,  and  is  accessible  by  rail  over  the  Buffalo 
New  York  and  Philadelphia  line,  as  well  as  the  Rochester  and  Pitts- 
burg railroad,  by  way  of  Machias  station,  which  is  about  one  mile 
distant  from  the  poor-house. 


20  Report  on  the  Chronic  Insane. 

The  board  of  supervisors  of  this  county,  in  1877,  made  an  ai)pro- 
priution  of  !?;l:i,000  to  provide  requisite  buildings  for  the  care  of  its 
chronic  insane.  A  committee  was  appointed,  consistinji  of  the  superin- 
tendent of  the  poor,  F.  Strickland,  and  supervisors,  E/Dusenbury  and 
Dr.  J.  Nichols.  This  committee  applied  to  the  State  Board  of  Chari- 
ties for  information  and  suggestions,  and  also  visited  various  institu- 
tions for  the  care  of  the  insane,  taking  time  to  perfect  their  plan,  be- 
fore entering  into  contracts  for  buildings. 

The  dejiartment  for  the  insane  is  located  on  the  county  farm,  near 
the  poor-house.  It  forms  a  group  of  frame  buildings,  entirely  distinct 
from  the  poor-house,  and  surrounded  by  ample  grounds  for  out-door 
recreation,  and  for  gardening  purposes. 

Officiah  and  employes.  —  The  })oor-house  affairs  are  now  directed 
by  one  superintendent  of  the  poor.  His  salary  is  $900  per  year. 
The  present  keeper,  "William  FoUett,  who  is  appointed  by  the  super- 
intendent, has  had  supervising  charge  for  the  past  twenty-two  years. 
His  compensation  is  §800  per  year.  He  has  a  married  assistant, 
resident  at  the  poor-house.  The  male  division  of  the  insane  depart- 
ment is  in  charge  of  an  attendant,  who  receives  $13  per  month,  and 
living.  He  lodges  in  a  cottage  occupied  by  the  male  insane.  The 
females  are  in  charge  of  a  matron,  who  receives  $2.50  per  week  with 
board.  She  sleeps  in  the  cottage  with  the  insane.  A  woman  cook  is 
employed  at  §2  per  week,  and  board.  The  keeper  prescribes  the  duties 
and  regulates  the  conduct  of  the  attendants.  No  paupers  are  employed 
in  the  care  of  the  insane. 

Medical  mqyervision.  —  The  county  physicians,  Doctors  King  and 
Ashley,  reside  within  half  a  mile  of  the  poor-house.  They  visit  the 
asylum  when  called  upon,  for  which  they  receive  $1  per  visit.  If 
two  patients  are  prescribed  for  at  any  one  visit,  the  charge  is  $1.50. 
All  ordinary  medicines  are  furnished  by  the  physicians.  In  case  of 
injuries^  requiring  surgical  operations,"  an  extra  charge  is  made.  A 
prescription   book  is  kept  in  the  institution,  but  no  case  book. 

Buildinfjs. —  The  group  of  buildings  consists  of  a  cottage,  centrally 
located,  for  the  keeper's  residence  and  the  office.  Directly  in  rear,  in  a 
one-story  building,  connected  by  an  open  corridor,  is  the  kitchen  with 
separate  dining-rooms  for  men  and  women.  On  each  side  of  the  last- 
named  building  are  two  cottages,  connected  with  the  former  by  open 
corridors.  These  may  be  closed  in  winter  by  movable  shutters. 
Each  cottage  is  two  stories  in  height,  and  accommodates  ai)out  thirty 
persons.  The  low^er  floors  are  used  for  day-rooms,  and  the  upper  for 
sleeping  apartments.  The  windows  have  two  sashes,  the  frame-work 
being  of  wood  and  the  interior  portions  of  iron.  They  are  hung  with 
cords,  pulleys  and  weights,  are  painted  white,  and  present  the  appear- 
ance of  the  windows  of  an  ordinary  dwelling.  There  are  no  high  fences 
nor  walls  of  any  kind  about  the  cottages,  which  appear  like  those  of 
home-life.  The  l)uildings  are  heated  by  steam,  generated  from  a  boiler 
beneath  the  kitchen,  with  radiators  in  the  various  rooms.  A  few  open- 
grate  fires  facilitate  ventilation.  The  accompanying  diagrams  show  the 
relation  of  the  buildings  to  each  other,  the  arrangement  of  the  various 
parts,  and  their  uses.  Plate  I  shows  the  ground  plan.  Plate  II  shows 
the  first  and  second  floors  of  the  superintendent's  residence.  Plate  III 
shows  the  first  floor  and  attic  plan  of  dining-hall.  Plate  IV  the  first 
and  second  floors  of  the  cottages  as  finally  built,  and  Plate  V  exhibits 


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Report  on  the  Chronic  Insane.  21 

the  cottage  for  patients  as  originally  planned,  but  subsequently  modi- 
led  in  accordance  witii  plate  IV  to  meet  appropriations. 

The  total  cost  of  the  whole  group  of  buildings,  including  boiler  and 
aeatiug  apparatus,  was  given  as  §13,270. 

It  is  believed  that  better  results  would  have  been  attained  had  the 
xpenditures  in  some  particulars  been  moderately  increased. 

Water  supply. — Water  is  brought  in  iron  pipes  from  a  spring  one 
mile  and  a  quarter  distant.  It  flows  into  a  reservoir  at  the  top  of  the 
poor-house  building,  and  from  that  point  is  distributed  throughout 
he  establishment,  and  likewise  carried  to  the  group  of  buildings  for 
the  insane.  The  supply  is  insufficient,  and  eflforts  are  being  made  to 
increase  it. 

Food. — The  keeper  says  :  "  The  diet  varies  according  to  the  season, 
ind  is  regulated  by  myself.  The  food  for  the  sick  is  prescribed  by  the 
physician.  The  diet  of  the  insane  for  breakfast  and  dinner  consists  of 
pork  and  potatoes,  bread  and  butter,  tea,  and  vegetables  in  their  season; 
for  supper,  corn-pudding  and  milk,  or  bread  and  milk.  Once  or  twice 
a,  weet,  codfish  ;  sometimes  fresh  fish  is  served  at  dinner.  They  have 
milk  once  a  day  during  about  six  months  of  the  year.  It  is  customary 
to  sweeten  coffee  and  use  milk  therewith ;  some  of  the  old  ladies  use 
sugar  in  their  tea.  In  winter  the  insane  have  but  two  meals  per  day. 
In  the  garden  we  raise  cabbages,  turnips,  beets,  carrots,  spinach,  let- 
tuce, onions,  tomatoes,  beans,  peas,  and  green  corn,  in  all  of  which  the 
insane  share.  We  aim  to  give  the  healthy  insane,  ordinary  farmers' 
living."  In  the  dining-room  there  are  in  use  plain  deal-tables,  with- 
out cloths,  crockery  table-v^are,  ordinary  knives  and  forks,  with  round 
top  stools  for  seats. 

Clothing. — In  summer  it  is  said  the  men  wear  cotton  or  woolen 
shirts,  as  directed  by  the  physician;  cotton  "denim"  jackets,  cotton  or 
woolen  socks,  ''cottonade"  pants,  shoes  and  straw  hats.  In  addition 
thereto  are  also  worn  in  winter  a  woolen  shirt,  or  flannel  vest  and  sack 
coat,  and  boots.  Many  of  the  patients  wear  drawers  of  canton-flan- 
nel. 

In  summer  the  women  wear  a  calico  dress,  cotton  underclothing, 
stockings  and  slippers  ;  in  winter  similar  clothing  is  worn  with  the 
addition  of  canton-flannel  drawers  and  under-wrapper. 

Bedding. — The  bedsteads  are  made  of  wood,  after  the  Willard  Asy- 
lum pattern,  having  hoop-iron  strap  bottom.  The  bed  furnishing 
consists  of  a  straw  tick,  mattress,  two  sheets,  and  home-made  quilts. 
During  the  day  a  counterpane  is  laid  over  the  bed,  which  at  night  is 
replaced  by  a  quilt.  It  is  stated  that  in  winter  additional  covering  is 
added. 

Employment. — At  the  time  of  visitation  there  were  forty-one  insane, 
nineteen  of  whom  were  meu  and  twenty-two  women.  The  out-door 
labor  of  the  men  consists  in  general  farm-work.  Some  plough,  har- 
vest grain,  care  for  the  stock,  cultivate  the  gardens,  and  in  the  fall 
assist  in  butchering  the  hogs.  In  the  winter  season  some  of  the  men 
are  employed  in  getting  out  wood  from  a  timber  lot  belonging  to  the 
county,  two  and  one-half  miles  away.  There  is  no  in-door  employ- 
ment for  the  men.  The  women  in-doors  are  engaged  in  sewing,  knit- 
ting, cleaning  house,  making  beds,  and  sweeping,  under  the  supervis- 
ion of  an  attendant.  Six  of  the  men  are  said  to  perform  a  fair  day's 
labor,  and  four  a  partial  day's  work.     The  keeper  said :  "  Nearly  all 


22  Report  on  the  Chronic  Insane.  I 

the  men  do  something  about  the  farm.     Twelve  of  the   women  per-| 
form  a  fair  day's  labor,  and  six  do  a  partial  day's  work.     The  labor  otj 
the  men  and  women  is  fairly  remunerative."     The  assistant  directs  the 
labor  of  tlie  men  when  out  of  doors,  and  the  matron  supervises  the'.' 
work  of  the  women  within  doors.  \ 

The  influence  of  labor  is  regarded  by  the  keeper  as  highly  beneficial.! 
He  further  said:  "It  would  be  difficult  to  carry  on  our  institution  asr 
economically  without  the  labor  of  the  insane.     With  labor  they  sleep 
better,  and  are  more  quiet.     We  are  very  careful  to  see  that  they  arc ' 
not   overworked.       If    disposed    to   overwork   they    are    sent  in    to  ■ 
rest.      The    employment    of    the    insane    about    the    farm    and    in 
domestic   work   has   resulted   in    some   cures  of    chronic   cases.     Ai 
woman  who  was  at  Utica  six  years  was  returned  here  at  the  age  or 
forty-five.  She  remained  in  the  asylum  nearly  two  years,  when  she  waF-- 
discliarged  cured.     This  happened  about  ten  years  ago.     She  has  noi"' 
been  in  an  asylum  since,  and  now  assists  in  managing  the  business  of 
her  father,  who  is  a  widower.     A  man  forty  years  of  age  was  returnedi 
here  from  Utica.     He  claimed  that  he  was  the  Almighty.     I  found  it 
impossil)le  to  do  any  thing  with  him.     At  length  I  told  him  that  we 
needed  help  to  drive  the  ox-team  and  thought  he  could  do  it.     I  said, 
if  willing  he  might  have  charge  of  the  oxen,  and  explained  the  farm' 
matters  to  him,     I  got  him  interested.     He  was  with  me  a  year  or  two,, 
and  was  discharged  cured.     This  was  some  fourteen  years  ago,  and  he 
has  had  no  relapse  since.     A  female  patient  from  Utica  was  after  a^ 
time  discharged,  but  experienced  a  relapse  and  Avas  brought  back. 
Finally  she  was  discharged  as  cured.     This  was  four  years  ago,  and  tht* 
woman  has  had  no  mental  trouble  since.     About  five  years  ago  a  man. 
was  returned  from  Utica.     He  was  here  about  six   months  and  then 
discharged.     He  has  not  since  been  returned,  and  I  believe  he  has  had 
no  relapse.     I  have  never  had  any  success  with  cases  of  self-abuse." 

Amusements,  etc. — There  are  no  out-door  amusements  for  the  men. 
In-doors,  they  play  checkers  and  read  newspapers,  which  are  sometimes 
supplied.  There  are  no  amusements  in  common  for  both  sexes. 
"  Occasionally,  "  the  keeper  says,  "  a  brass  band  comes  and  gives  therai 
music,  but  not  very  often.  A  company  of  traveling  bell  ringers  came- 
here  last  fall  and  played  an  hour. " 

The  interior  walls  of  the  cottages  are  destitute  of  pictures,  andl 
wholly  unadorned. 

Restraint. — In  the  institution  are  two  ordinary  cribs,  secured  by 
padlock.  The  keeper  said:  "  Three  women  are  put  in  the  cribs,  about 
once  a  week,  for  a  short  time.  These  cribs  are  seldom  used  for  the- 
men."  We  have  in  this  department  one  restraining  chair  and  three; 
muffs.  The  latter  have  not  been  used  for  a  long  time  and  are  now  only 
brought  into  requisition  when  taking  violent  patients  to  Utica.  Two 
camisoles  are  used  in  the  women's  ward  ;  also  vihen  transferring  patients 
toUtica.  I  direct  and  regulate  the  restraint  through  general  instructions 
to  the  attendants.  My  orders  are  to  be  very  careful.  No  restraint  book 
is  kept.  Punishment  is  inflicted  upon  the  insane  solely  in  self-defense, 
and  then  only  in  cases  of  gi-eat  emergency  and  not  as  a  means  of  disci- 
pline. For  instance,  an  Italian  once  raised  an  ax  over  my  head,  in- 
tending to  kill  me.  I  was  obliged  to  'knock  him  over,'  but  such  cases' 
are  very  rare.     I  find  women  more  difficult  to  manage  than  men.  " 

Farm.  —  The  farm  is  in  excellent  condition,  being  well  fenced,  sub- 


Eeport  on  the  Chronic  Insane.  23 

drained  and  free  from  weeds.  It  is  also  productive,  having  long  been 
subjected  to  a  thorough  system  of  husbandry.  The  farm  buildings 
which  are  painted,  are  commodious,  in  good  condition,  and  rest  on 
solid  masonry  foundations.  The  stock  yards  are  supplied  with  spring 
water.  All  available  pauper  labor  is  utilized  on  the  farm.  According 
to  the  keeper's  statement  "  there  is  not  an  able-bodied  male  pauper  in 
the  poor-house  department." 

General  observations. —  In  the  quarters  formerly  occupied  by  the  in- 
sane in  the  poor-house  building  are  five  patients.  One  of  the  men  is  very 
violent  "  nearly  the  whole  time  ;"  another  is  so  "by  spells;"  and  one 
female  is  said  to  be  continuously  violent  and  disturbed.  Two  of  the 
women  are  quiet,  and  are  serviceable  in  doing  house  work  in  the  poor- 
house  department.  The  wards  occupied  by  the  violent  and  disturbed, 
are  particularly  described  in  the  report  transmitted  to  the  Legislature, 
April  18,  1879,  Senate  Document  No.  50.  The  idiots  are  provided  for 
in  a  building  situated  in  a  yard  in  rear  of  the  poor-house. 

The  laundry  is  in  a  detached  building  of  the  poor-house  group, 
and  in  rear  of  the  main  building.  It  is  furnished  with  steam-boiler, 
hot  and  cold  water,  and  is  conveniently  arranged  with  wash-room, 
ironing-roora  and  drying-room,  heated  by  steam. 

During  the  past  year  a  small  hospital  building  has  been  erected, 
about  midway  between  the  poor-house  and  cottage  group.  It  \3  a 
wooden  structure,  consisting  of  a  main  building,  with  a  rear  wing. 
It  has  two  wards,  one  for  men  and  one  for  women  ;  a  room  on  each 
side  for  a  male  and  a  female  attendant;  two  bath-rooms,  kitchen,  etc. 
The  building  has  chimneys  at  each  end,  and  it  is  expected  that  heat- 
ing and  ventUating  by  means  of  open  grate  fires  will  be  adopted.  The 
structure  was  in  process  of  completion  at  the  time  of  my  visit. 

A  special  register  of  the  insane  is  kept.  Certificates  of  insanity  are 
also  kept  on  file  in  the  ofiice.  Chronic  insane  are  admitted  by  order  of 
the  superintendent  of  the  poor,  or  overseer  of  the  poor. 

All  medicines  are  dispensed  hj  the  physicians,  and  in  their  absence 
by  the  attendants. 

The  medical  profession,  it  is  said,  do  not  manifest  any  special  _  in- 
terest in  the  institution  ;  neither  do  the  citizens  appear  to  be  particu- 
larly interested  except  through  motives  of  curiosity.  In  the  words  of 
the  keeper  :  "We  have  more  visitors  during  the  summer  months  than 
we  think  desirable.  It  has  a  disturbing  influence  on  the  patients.  A 
great  many  pic-nics  are  held  within  a  few  miles  of  the  institution,  and 
this  brings  large  numbers  here  out  of  curiosity.  Upon  one  occasion 
the  visitors  numbered  over  two  hundred.  Wednesdays  and  Fridays  are 
designated  as  regular  visiting  days." 

The  acute  insane,  it  was  said,  are  generally  transferred  to  State 
asylums  within  five  days.  Certificates  of  insanity  accompany  the  cases 
sent  to  Utica. 

Paying  patients,  residents  of  the  county,  are  admitted  into  the  insti- 
tution at  a  per  capita  charge  of  83  per  week.  The  keeper  remarked  : 
"  Their  care  and  treatment  are  very  much  the  same  as  in  the  case  of 
the  other  patients.  They  are  possibly  a  little  favored  to  meet  the 
wishes  of  friends." 

The  visitation  was  made  on    August  12,    1881,    by    Commissioner 
Letchworth,  accompanied  by  Professor  A.  0.  Wright,  Secretary  of  the 
Wisconsin  State  Board  of  Charities,  who  made  an  oflficial  inspection  of 
4 


24  Report  on  the  Chronic  Insane. 

the  building  and  plans,  with  a  view  to  possible  utilization  of  the  latter 
by  the  Wisconsin  Board. 

Chautauqua  County. 

The  Chautauqua  county  poor-house  is  located  five  miles  from  May- 
ville  in  a  north-easterly  direction  ;  one  mile  from  Point  Chautauqua, 
and  half  a  mile  north  of  the  hamlet  of  Dewittville. 

Tiio  insane  department  is  situated  one  hundred  feet  north  of  the 
poor-house  building.  It  comprises  two  brick  structures,  connected  by 
an  enclosed  corridor,  forty  feet  long  and  twelve  feet  wide. 

OfficiaU  and  employes.  —  The  atfairs  of  tiie  poor-house  are  con- 
trolled by  a  board  of  three  superintendents  of  the  poor. 

The  keeper  of  the  poor-house  is  appointed  by  the  board  of  super- 
intendents. The  present  incumbent  lias  tilled  this  })osition  for  a  period 
of  nineteen  years;  his  wife  acting  a.s  matron.  Their  joint  remuner- 
ation is  $800  per  year,  with  living.  Tiie  insane  department  is  under 
the  sole  charge  of  another  keeper,  who  is  likewise  appointed  by  the 
board  of  superintendents.  His  salary,  including  that  of  his  wife,  who 
officiates  as  matron  of  this  department,  is  $6oO  per  year,  with  living. 
One  attendant  has  charge  of  the  men  while  they  are  at  work  on  the 
farm.  He  sleeps  in  the  asylum  and  his  compensation  is  816  per  month, 
with  board.  Aside  from  the  single  male  attendant  referred  to,  there 
are  no  paid  attendants  in  this  department.  A  female  cook  is  employed 
for  the  keeper's  family  at  83  per  week,  and  a  girl  for  general  work  in 
the  insane  department  at  $2  per  week.  No  paupers  were  found  in 
charge  of  the  insane. 

Medical  supervision. —  The  county  physician,  T.  C.Wilson,  M.  D., 
resides  at  Dewittville.  He  visits  the  institution  once  a  day,  and  oftener 
if  required.  His  compensation  is  $250  per  year.  All  the  medicines 
are  furnished  by  the  county.  They  arc  dispensed  by  the  physician, 
and  in  his  absence  by  the  keeper.  There  is  no  extra  charge  for  surgical 
operations.  No  prescription,  nor  "casebook"  is  kept.  The  insane 
are  registered  in  the  keeper's  office  at  the  poor-house,  where  the  cer- 
tificates of  insanity  are  also  kept  on  file.  A  record  book  prepared  by 
Dr.  Wilson,  and  kept  in  the  insane  department,  was  shown,  designed 
to  give  a  complete  history  of  each  case.  A  copy  of  this  will  be  found 
in  the  appendix  hereto.  It  should  be  stated,  however,  that  these 
records  fall  short  of  the  intention.  The  physician  said :  ''  Owing  to 
the  meagre  information  furnished  by  the  papers  accompanying  the 
patient,  the  keeping  of  this  history  is  incomplete  and  very  unsatis- 
factory. I  would  recommend  that  this  negligence  be  remedied  by 
statute.  There  are  no  consulting  physicians.  The  medical  profession 
manifest  little  interest  in  the  institution." 

Buildiiigs. —  The  principal  building  of  the  insane  dei)artment,  one 
hundred  by  thirty-six  feet,  was  erected  in  1867  at  a  cost  of  about 
$14,000.  It  is  two  stories  high  above  a  basement,  with  shingled  roof. 
The  smaller  building  in  the  rear,  eighty  by  forty  feet,  also  two  stories 
above  basement  celhir,  with  slate  roof,  was  built  in  1876  and  cost 
about  $8,000. 

In  the  basement  of  the  front  building  is  the  asylum  kitchen,  the 
keeper's  kitchen,  keeper's  dining-room,  the  laundry,  })antry  and  store- 
room, also  two  dining-rooms,  one  for  each  sex,  as  well  as  bath-rooms. 


Report  on  the  Chronic  Insane.  25 

At  each  end  is  a  furnace-room.  The  basement  communicates  with  the 
upper  floors  by  stairways  at  each  end  of  the  building. 

On  the  first"^ floor  are  the  office  and  family  rooms  of  the  keeper  ;  a 
ward  for  male  patients  at  the  left ;  and  one  for  females  at  the  right. 

The  second  floor  forms  a  large  ward  for  men. 

The  basement  of  the  rear  building  contains  the  steam  boiler  for 
heating,  and  is  mainly  used  for  storage  of  coal.  The  two  floors  above 
are  intersected  by  a  central  hall,  in  each  of  which,  on  both  floors,  are 
wards  for  men  and  women.  The  inmate's  kitchen  adjoins  the  two  din- 
ing-rooms. It  is  twenty-four  feet  by  sixteen.  The  floor  is  flagged. 
It  contains  a  cooking  range,  cooking  utensils,  etc. ;  also  shelves,  upon 
which  was  folded  bed  linen.  The  laundry  adjoining  is  twenty-six  by 
sixteen  feet.  It  has  a  stationary  wash-box,  with  six  compartments , 
two  of  which  are  used  for  washing  vegetables.  These  are  supplied 
with  cold  water  only.  Here  also,  side  by  side,  are  two  cauldron  stoves, 
one  used  for  boiling' clothes,  and  the  other  for  food.  Old  shoes  and 
miscellaneous  clothing  were  about  the  apartment  in  some  confusion. 

On  the  wall  were  hung  kitchen  utensils  and  men  and  women's  gar- 
ments.    Hot-air  and  smoke  pipes  pass  through  the  room. 

The  two  bath-rooms  in  the  basement  are  seven  feet  four  inches  by 
eleven  feet.  The  floors  are  laid  with  cement  and  the  windows  grated. 
Cold  water  is  supplied  in  pipes,  while  hot  water  is  brought  in  pails. 

A  small  hospital  department  for  the  use  of  the  poor-house  inmates 
is  situated  between  the  poor-house  building  and  the  insane  depart- 
ment.    It  is  a  two-storied  brick  building. 

Heating  and  ventilation. — The  old  asylum  building  is  heated  by 
two  coal-burning  furnaces,  located  at  each  end  of  the  building,  in  the 
basement  cellar,  whence  the  heat  is  carried  by  pipes  to  the  first  and 
second  stories. 

The  new  building  is  heated  by  a  boiler  in  the  basement,  the  steam 
being  distributed  through  the  rooms  by  means  of  pipes  along  the 
walls. 

The  ventilation  is  by  means  of  wall  flues.  In  the  old  building,  the 
openings  (of  which  there  is  one  in  each  room),  are  only  four  by  six 
inches,  and  these  are  covered  by  plates,  leaving  only  four  small  spaces 
for  the  air  to  pass. 

Window  ventilation  is  mainly  relied  on. 

The  window  sashes  of  the  old  buildings  are  of  wood — two  sashes  — 
hung  with  cords  and  weights. 

Sewerage. —  A  main  sewer  extends  from  the  poor-house  building  to 
the  creek,  about  eighteen  rods  distant.  It  is  built  of  ten-inch  socket- 
tile,  with  cemented  joints.  From  the  asylum  buildings,  an  eight-inch 
socket-tile,  cemented,  is  laid  to  the  main  sewer. 

These  were  said  to  be  properly  trapped.  The  water  from  the  roofs 
of  the  two  buildings  discharges  into  the  sewers  by  means  of  con- 
ductors. 

Water  supply.  —  The  source  of  water  supply  is  from  a  spring  elevated 
one  hundred  feet,  and  about  three-quarters  of  a  mile  distant  from 
the  building.  The  water  is  brought  thence  through  a  one-inch  iron 
pipe. 

The  poor-house  and  insane  department  have  two  hundred  feet  of 
three-fourth  inch  hose  with  a  one-fourth  inch  nozzle,  as  a  protection 
against  fire. 


26  Report  on  the  Chronic  Insane. 

Diniyig-room  and  food. —  The  dining-rooms  have  each  two  win- 
dows—  double  sash,  twelve  lighted,  glass  eight  by  ten,  protected 
by  horizontal  gratings  of  round  iron  rods.  The  floors  are  flagged  with 
stone.  These  rooms  are  much  below  the  surface  of  the  ground. 
Three  and  a  half  feet  above  the  floor  the  walls  evidenced  dampness. 
The  plastering  is  laid  directly  upon  the  stone.  Each  dining-room  is 
twenty-eight  feet  eight  inches  by  fifteen  feet  six  inches,  with  nine 
feet  ten  inch  ceiling.  In  each  of  these  rooms  were  three  deal  tables 
laid  without  cloths.  Eound  top  stools  are  used  for  seats.  The  table 
ware  was  of  crockery  and  tin  with  ordinary  knives  and  forks. 

The  food  is  regulated  by  the  keeper.  lie  gave  the  following  as  the 
regular  diet :  "  In  summer,  for  breakfast  they  have  bread  and  butter, 
potatoes,  gravy,  apple  sauce  and  tea. 

"  For  dinner,  meat,  potatoes,  bread  without  buttei',  and  garden  veg- 
etables ;  tea  is  omitted.  Pork  and  beaus  are  furnished  once  a  week. 
In  winter,  onions  twice  a  week  are  added. 

"  For  supper,  mush  and  milk. 

"  The  food  for  the  sick  is  taken  from  my  table. 

"  Three  meals  are  supplied  the  insane  throughout  the  year  every 
day,  except  Sundays,  when  only  two  are  given." 

Clothing. — The  clothing  was  given  as  follows  : 

"  In  the  summer  the  men  generally  wear  cotton  shirt,  linen  over- 
shirt,  cottonade  pants,  cotton  stockings,  shoes,  and  straw  hat.  The 
women's  dress  consists  of  chemise,  blue  or  butternut  colored  gown, 
cotton  skirt,  cotton  stockings,  shoes,  and  sun-bonnet.  In  winter  the 
men  working  out  of  doors  have  woolen  coat,  vest  and  pants,  woolen 
wrapper  and  drawers,  woolen  mittens,  cap,  woolen  stockings,  and 
boots. 

"Those  iu-doors  have,  in  addition  to  their  summer  dress,  woolen 
underclothing  and  felt  hat. 

"  The  women  are  also  supplied  with  canton-flannel  wrappers  and 
drawers,  and  woolen  stockings." 

Employment.  —At  the  time  of  visit  there  were  eighty-one  patients 
—  thirty-nine  men  and  forty-two  women.  Twenty  of  the  men, 
it  was  said,  were  engaged  in  cutting  and  drawing  wood,  pulling  beans, 
and  attending  masons.  Seven  women  were  in  the  kitchen  doing 
housework,  and  eight,  it  was  said,  were  sewing  and  mending.  Those 
engaged  in  the  latter  operations  were  working  under  instructions, 
having  no  attendant  with  them.  Twenty  women  were  in  the  halls. 
•''  Ten  of  the  men,"  the  keeper  said,  ''  do  a  fair  day's  labor,  and  twenty 
a  partial  day's  work."  He  estimated  that  about  one-third  of  the  labor 
in  both  the  male  and  the  female  departments  was  remunerative.  The 
physician  regarded  the  influence  of  labor  as  beneficial,  promoting 
sleep  and  greater  quietude. 

There  were  but  two  men  who  were  in  danger  of  doing  overwork, 
and  they  were  "  only  sent  out  for  half  a  day." 

Amusements,  etc. —  It  could  not  be  ascertained  that  there  were  in- 
door or  out-door  amusements  of  any  kind.  Seven  county  papers  are 
taken  at  the  poor-house. 

Classification. — The  men,  it  was  stated,  are  classified  by  putting 
together  those  whose  liabits  of  life  are  the  same.  '•  We  place  some  of 
the  best  of  the  inmates  in  every  ward —  those  who  have  the  best  judg- 


Eeport  on  the  Chronic  Insane.  27 

ment  —  to  look  after  the  others  and  report  ■when  the  attendant  is 
absent." 

No  special  provision  is  made  for  epileptics,  except  that  one  occupied 
an  open  crib  at  night. 

One  of  the  inmates  has  proclivities  for  arson. 

Restraint. —  There  are  in  the  insane  department  two  cribs  with 
covers  ;  two  mnflFs  with  stra^js  and  padlocks  ;  two  leather  straps  and 
wristlets  (both  in  use  at  the  time  of  the  visit);  three  pairs  of  hand- 
cuffs, used  on  the  violent  or  "new  cases."  The  physician  said:  "If  I 
find  a  patient  with  handcuffs  on,  I  have  him  removed  and  see  if  he 
cannot  be  controlled  without  them."  The  keeper  said:  "The  daily 
number  in  restraint  for  the  year  averages  three.  I  have  not  found  it 
necessary  to  confine  patients  to  their  rooms,  except  in  one  instance 
during  the  past  year.  This  asylum  has  no  specified  mode  of  punish- 
ment. Sometimes  we  use  handcuffs,  restraining  their  hands  behind 
them.  I  use  the  handcuffs  rather  than  confine  them  to  their  rooms. 
I  think  it  has  a  better  effect  to  have  the  other  patients  see  them  in  re- 
straint." 

No  restraint  book  is  kept. 

General  ohservatiojis. —  In  making  a  general  tour  of  inspection  the 
first  ward  entered  was  that  occupied  by  men  on  the  first  floor,  at  the 
south  side  of  the  old  building.  Here  the  central  hall  is  fifteen  and  a 
half  by  thirty-eight  feet,  with  a  number  of  small  rooms  on  each  side 
for  patients.  Light  is  admitted  by  two  windows  at  the  end,  which  are 
protected  by  wooden  studding.  The  ceiling  is  painted  and  the  floor 
laid  with  boards  about  twelve  inches  wide.  Stationary  seats  were 
found  arranged  along  the  sides  of  the  hall,  divided  by  iron  hand-sup- 
ports, some  having  one  and  others  five  spaces.  The  papered  walla 
at  the  south  end  are  dark  and  stained,  said  to  have  been  "caused  by 
leakage  from  the  pipe  above."  From  the  ceiling  hung  two  kerosene 
lamps,  and  two  cheap  prints  were  displayed  on  the  walls.  The  room 
is  heated  by  two  registers  in  the  floor,  protected  by  iron  straps.  One 
of  these  gratings  had  been  entirely  broken  out,  leaving  the  hot-air 
flue  exposed  to  the  feet.  Through  the  hall,  passes  the  smoke-pipe 
from  the  furnace,  wholly  unprotected;  and  against  the  wall  is  the  hot- 
air  pipe  encased  in  wood,  conveying  heat  to  the  floor  above. 

The  water-closet  is  in  the  room  at  the  outer  corner,  as  are  the  closets 
in  the  other  wards.  The  pipe  below  w^as  said  to  have  a  trap.  In  the 
attic  is  a  tank,  which  supplies  rain  water  collected  from  the  roof  to 
cleanse  the  basin  under  the  seat.  The  sujoply  of  water  appeared  in- 
suiiicient,  and  the  closets,  all  similarly  arranged,  were  at  the  time  of 
visit  quite  offensive.  Stored  m  these  closets  were  brooms,  mops,  etc. 
In  one  room,  used  as  a  clothes-press,  were  shoes,  boots  and  clothing 
hung  irregularly  on  cut  nails.  Some  of  the  clothing  belonged  to  pa- 
tients. The  windows  of  the  small  rooms  have  two  sashes,  with  twelve 
panes  of  glass.  They  are  grated  by  vertical  iron  bars.  The  doors  are 
one  foot  eleven  inches  wide  and  paneled.  There  is  an  open  space 
above  the  door,  in  which  are  three  upright  studs.  All  of  the  single 
rooms  in  the  front  side  measure  four  and  one-half  by  eight  and  one- 
third  feet,  with  ten-foot  ceilings,  affording  only  three  hundred  and 
seventy-five  cubic  feet  of  air  space.  The  ventilation  is  as  elsewhere 
described.  With  one  exception,  each  of  these  rooms  contains  one  bed. 
The  bedsteads,  which  are  narrow,  are  of  iron,  with  strap  iron  bottom. 


28  Report  on  the  Chroxic  Insane. 

The  plastering  in  most  of  these  rooms  was  much  patched.  This  was  the 
case  to  a  great  extent  throiigiiout  the  old  building,  and  in  some  parts 
it  had  become  detached.  Much  patching  had  left  small  crevices  or 
fissures,  the  margins  of  which  had  a  peppery  appearance,  unmistakably 
indicating  that  bed  vermin  had  gained  a  strong  foothold.  The  semi- 
annual whitewashing,  preceding  the  fall  visitation  of  the  board  of 
supervisors,  had  not  yet  been  made,  and  the  interior  was  perhaps 
presented  in  its  worst  form. 

In  several  of  the  rooms  tiie  presence  of  bed  bugs  was  more  con- 
spicuous from  blood  smearings  on  the  wall,  where  patients  had  crushed 
these  insects  with  their  fingers.  In  some  of  the  rooms  in  the  men's 
ward,  the  walls  were  much  discolored  by  tobacco  juice  expectorated 
by  the  patients  while  in  bed.  The  bedticks  in  many  instances  in 
this  and  other  jiarts  of  the  old  building  were  deficient  in  straw  and 
had  been  so  long  worn  as  to  be  unfit  for  use.  The  unequal  distribu- 
tion of  the  worn-out  straw  must  have  been  a  source  of  great  discom- 
fort. In  some  of  the  beds  there  was  no  protection  to  the  person  from 
the  iron  straps  beneath.  The  keeper  said  :  "  The  straw  is  unevenly 
spread  because  the  patients  make  their  own  beds  before  retiring 
for  the  night.''  The  pillows  were  made  of  feathers  but  were  very 
small ;  the  bed  covering  appeared  ample  for  the  season. 

The  women's  ward,  at  the  opposite  end  of  this  building,  on  the  same 
floor,  has  a  central  hall,  fifteen  feet  six  inches  by  forty-five  feet ;  with 
nine  feet  ten  inch  ceilings,  and  has  small  rooms  on  each  side.  The 
windows  are  similar  to  those  in  the  men's  ward.  The  floor  and  ceiling 
are  painted  yellow,  the  room  is  heated  by  two  registers  in  the  floor  : 
smoke  and  hot-air  pipes  pass  through  the  floor  above.  The  walls  at 
each  end  are  papered  ;  the  north  wall  appeared  stained  and  mildewed 
by  leakage  from  above.  The  room  is  furnished  with  one  bureau,  a 
small  wash-stand,  looking  glass,  a  few  seats  with  backs,  and  several 
wall-benches,  with  iron  supporting  straps  at  intervals.  The  side  rooms 
were  originally  four  feet  five  inches  wide  by  nine  feet  long,  with  nine 
feet  ten  inch  ceiling.  The  partition  between  a  number  of  these  smaller 
rooms  has  been  removed,  doubling,  and  in  one  case  trebling,  the  size  ; 
there  are  now  but  six  of  the  small  rooms  on  this  floor.  One  is  used  as 
a  clothes-press.  In  one  of  the  bed-rooms,  without  other  furniture,  a 
woman  was  sitting  on  the  bed,  sewing ;  a  patch  was  broken  out  of  the 
ceiling  overhead  and  some  dresses  were  hung  on  nails  against  the  wall. 
8he  had  a  basket  of  patch  work,  also  some  straw  braid  and  was  engaged 
in  making  straw  hats.  The  work  was  neatly  done  ;  she  was  said  to  be 
a  quiet  patient.  Here  was  likewise  marked  evidence  of  bed  vermin. 
The  woman  said:  "The  bugs  are  beginning  to  crawl."  In  another 
room  beside  the  usual  bed  and  bedding,  was  a  chair,  trunk,  old 
fashioned  rocking  chair,  and  clothes  upon  nails  in  the  wall.  Another 
had  a  rag  carpet  rug  on  the  floor,  a  shawl  in  the  window  for  a  curtain 
with  a  couple  of  books  and  some  specimens  of  needle  work. 

The  plastering  on  the  wall  was  patched,  and  the  ceiling  broken. 
There  was  a  manifest  lack  of  attention  to  details  throughout.  This 
was  further  evidenced  in  the  fastening  of  one  of  the  doors,  which  was 
secured  bv  a  tow  string  attached  to  the  knob,  with  nail  driven  into 
the  door-casing.     The  lower  hinge  of  the  door  was  broken. 

The  men's  ward  on  the  upper  floor  extends  throughout  the  whole 
length  of  the  building.     The   central    hall   is  eighty  feet   long  and 


.  Repoet  on-  the  Chronic  Insane.  29 

fifteen  and  a  half  feet  wide,  with  windows  at  each  end,  having  small 
rooms  on  both  sides. 

The  floor  is  of  wide  boards,  unpainted.  One  of  the  four  registers 
was  protected  by  iron  straps  ;  the  perforated  plate  below  was  broken. 
The  smoke-pipe  from  the  furnace  passes  into  the  chimney  through  a 
partition,  over  a  bed  in  one  of  the  rooms.  It  was  very  much  battered, 
and  a  large  hole  was  visible  at  one  of  the  joints.  The  walls  of  this 
room  were  cheaply  papered,  two  kerosene  lamps  hung  overhead  ;  a 
wash  sink  at  one  end  was  supplied  with  cold  water.  There  were  no 
decorations  on  the  walls  and  no  furniture  in  the  room.  At  each  end 
is  a  water-closet,  of  the  same  dimensions  and  pattern  as  those  of  the 
lower  wards  ;  the  atmosphere  therefrom  was  offensive. 

The  rooms  contain  one  bed  ;  those  on  the  front  side  being  four  feet 
five  inches  by  eight  feet  eight  inches,  and  those  on  the  opposite  side, 
seven  and  one-half  by  nine  feet.  The  bed  furnishings  were  of  the  same 
character  as  those  already  described,  and  seemed  in  need  of  attention. 
The  walls  in  the  sleeping-rooms  were  broken  and  patched  ;  in  one 
room  hung  several  chains,  which  the  keeper  said  had  not  lately  been 
used.  One  patient  was  lying  in  bed  while  elsewhere  another  was  on  the 
floor. 

The  attic  of  the  old  building  is  used  mainly  for  storage  and  drying 
clothes  in  bad  weather.  The  windows  in  the  corridor  connecting  the 
two  buildings  are  of  good  size,  protected  on  the  outside  by  iron  bars 
and  on  the  inside  by  wire  screen  work. 

The  windows  in  the  new  building  are  of  the  same  kind,  having  two 
sashes,  the  outside  bars  in  eight-inch  and  twelve-inch  squares,  with 
inside  wire  screens. 

In  the  hall  on  the  first  floor  of  the  new  building  is  a  staircase  with 
bluckwaluut  hand-rail  and  balusters.  The  flooring  and  wainscoting  of 
the  hall  are  of  ash,  the  walls  are  of  brick,  whitewashed. 

The  first  floor  on  the  south  side  of  the  hall  is  used  for  men.  The 
day-room  is  thirty  by  eighteen  and  a  half  feet,  with  a  height  of  ten 
feet  three  inches;  adjoining  is  a  one-seated  water-closet  and  a  small 
wash-room  or  lavatory,  with  galvanized  sink  and  a  wash  dish.  In  the 
men's  day-room  the  walls  are  of  brick,  whitewashed,  as  is  the  case  in  the 
other  rooms  throughout  the  building.  Six  wooden  chairs  with  bent 
rail  were  secured  to  the  floor  by  an  iron  rod.  Nine  wooden  chairs 
of  the  same  pattern  were  secured  to  a  plank  and  bolted  to  the 
floor.  On  the  walls  were  a  few  colored  prints.  Adjoining  this  room 
and  opening  into  it  are  two  dormitories,  each  seventeen  by  eighteen 
feet  six  inches.  Each  has  beds  on  iron  bedsteads,  two  feet  eight 
inches  in  width.  The  bedding  was  better  than  that  in  the  old  build- 
ing. Some  of  the  beds  lack  a  sufficiency  of  straw,  although  the 
keeper  said  they  "were  filled  once  a  week." 

No  chairs  were  in  these  dormitories. 

The  opposite  end  of  the  building,  across  the  hall,  is  occupied  by 
women,  and  is  the  counterpart  of  the  ward  just  described.  In  this 
ward  was  likewise  evidence  of  a  lack  of  care  and  supervision.  Sitting 
on  the  floor  in  the  water-closet  was  a  young  woman  with  her  limbs  in- 
decently exposed.  The  water-closets  in  this  building  are  cleansed  by 
water  taken  from  the  sink  in  the  adjoining  room,  and  ]ioured  into  the 
chamber  beneath  the  seat.  This  was  manifestly  ineffectual  and  the 
atmosphere  in  all  the  closets  was  highly  objectionable. 


30  Report  on  the  Chronic  Insane. 

In  one  of  the  dormitories  adjoining  the  day-room  are  six  rooms  and 
in  the  other  five.     One  of  them  contains  a  crib. 

The  floor  above  is  partitioned  off  as  below,  into  women's  wards  at 
each  end  of  the  building.  They  are  similar  in  size  and  description  to 
the  rooms  below. 

In  the  day-room  by  a  window  sat  a  bare-footed  young  woman  knit- 
ting. Her  hair  was"  combed,  her  dress  neat,  and  her  appearance 
comelv. 

Another  patient,  an  elderly  woman,  wearing  spectacles,  her  hair 
neatlv  combed,  was  well  dressed  and  wore  a  ribbon  around  her  neck. 
She  was  making  a  bedtick.  She  had  also  done  some  straw-braidiug, 
a  sample  of  which  was  shown.  Upon  a  small  deal  table  were  a  number 
of  books,  some  papers  and  boxes,  all  in  order.  The  patient  last 
referred  to,  had  flowers  by  her  side  at  the  window  and  had  evidently 
seen  days  of  thrift  and  prosperity. 

In  rear  of  the  old  building  and  extending  along  the  sides  and  ends 
of  the  new  structure  are  vards,  one  for  men  and  one  for  women.  Both 
are  irregularly  shaped.  The  men's  yard  is  one  hundred  and  twenty- 
five  feet  in  length,  with  an  average' middle  width  of  forty-two  feet. 
This  is  enclosed  by  a  tight,  rough  board  fence,  fourteen  feet  high. 

Absence  of  supervision  was  deplorably  manifest  in  the  men's  yard. 
Here  a  man  neglected  in  appearance  was  observed  with  neither  hat, 
coat  nor  vest,  and  having  his  person  indecently  exposed.  He  stood 
facing  and  in  full  view  of  the  women  in  the  second  story  of  the 
women's  ward.  Another  patient,  said  to  be  an  idiot,  was  lying  in  the 
dirt  under  the  platform  of  the  steps  we  descended,  which  were  about 
three  feet  from  the  ground.  He  was  sparsely  clad,  while  his  clothes 
and  hair  were  filled  with  dust.  His  person  was  likewise  indecently 
exposed.  The  yard  was  thinly  covered  with  grass  mingled  with  short 
weeds,  and  was*  in  part  rough  with  small  stones  or  gravel.  At  one 
end  in  a  pavilion,  with  seats,  were  two  barefooted  men.  In  one 
corner  of  the  yard,  in  close  proximity  to  the  pavilion  is  a  privy.  The 
keeper  said  "  the  night-soil  which  falls  upon  the  ground  is  removed 
every  three  weeks."  In  the  privy  were  two  men,  both  barefooted  and 
hatless,  one  being  on  the  floor.  There  were  in  all  eight  men  in  the 
yard.  Before  leaving,  women  at  the  windows  betrayed  some  excite- 
ment and  attracted  attention  by  violent  gesticulation  and  loud  talking. 

The  woman's  yard  on  the  opposite  side,  and  which  by  its  location 
is  overlooked  by" the  men's  large  ward  in  the  old  building,  is  about 
one  hundred  and  fifty  feet  in  length,  and  averages  sixty  feet  in 
width.  It  is  inclosed  by  a  tight,  rough  board  fence,  twelve  feet 
high.  Centrally  located  in  the  yard  is  a  pavilion  with  seats  around 
its  outer  limit.*  In  place  of  a  door,  the  large  privy  has  an  opening 
eighteen  inches  wide.  The  keeper  said  "  the  night  soil  is  removed 
from  this  every  two  weeks."  The  center  of  the  yard  was  thinly 
grassed,  but  along  the  fence  the  sod  was  worn  into  a  path  by  the 
tread  of  feet.  In  this  yard  were  sixteen  women.  Four  were  on 
benches  in  the  pavilion,  four  were  seated  on  the  grass,  and  others 
were  standing  or  walking,  all  without  bonnets  or  hoods.  The  hair  of 
some  was  disheveled.  One  had  a  handkerchief  over  her  head, 
another  wore  a  night-cap,  while  a  third  wore  dried  grasses  made 
into  a  sort  of  bonnet.  Nine  of  the  women  were  dressed  in 
blue  jean  wrappers.     The  others  wore  calico  dresses.     The  day  was 


Repokt  on  the  Chronic  Insane.  31 

oppressively  hot.  Four  of  the  women  were  uncomfortably  seated  on 
the  ground  in  the  scorcliing  sun.  One  old  woman  crouched  barefooted 
under  the  doorway  platform,  which  is  but  a  few  feet  from  tlie  ground. 
Her  head  was  wrapped  in  a  piece  of  cotton  quilt,  tied  with  cord  or 
small  rope.  Her  gown  was  turned  up  about  her  neck,  while  her  right 
arm  was  bandaged  with  ragged-looking  cloths.  She  approached  us 
protesting  that  her  right  arm  was  broken.  In  her  hand  was  a  tin  cup 
containing  bread,  of  which  she  was  eating.  She  said :  "  That  woman 
(pointing  to  another)  has  broken  my  arm,  and  is  very  ugly."  Mean- 
while the  woman  referred  to,  advanced  toward  her  accuser  in  a  threat- 
ening manner.  The  keeper  stated  that  her  broken  arm  was  merely  a 
delusion. 

In  this  county,  the  county  judge  commits  to  the  poor-house  or  to 
the  State  asylum,  as  the  facts  of  the  case  may  warrant.  The  physician 
thinks  it  would  be  better  if  all  cases  of  lunacy  were  first  committed  to 
the  State  asylum,  and  thence,  when  proper,  transferred  to  the  coun- 
ties. 

As  to  the  number  of  inmates  who  had  sometime  been  treated  in 
State  asylums,  the  keeper  said:  ^'We  have  no  means  of  ascertaining 
this,  as  the  commitments  or  records  do  not  show  the  fact." 

The  price  charged  for  paying  patients  is  $2  per  week,  and  none  are 
received  from  other  counties.  The  number  of  paying  patients  in 
the  institution  at  the  time  of  visit  was  thirteen.  The  total  amount 
received  for  this  class  of  patients  for  the  year  ending  June  30,  1881, 
was  $562.28. 

The  cost  of  maintaining  the  insane  is  not  kept  separately. 

As  bearing  upon  the  existing  needs  of  the  asylum  the  keeper  said  : 
**  Some  few  things  might  be  furnished  that  would  improve  matters, 
but  on  the  whole  I  think  they  are  pretty  well  provided  for.  Most  of 
the  time  we  are  short  of  help.  We  can  get  along,  but  it  would  be 
profitable  to  have  more  help."  He  thouglit  in  administering  the  af- 
fairs of  the  department  it  was  necessary  to  consult  the  interests  of  the 
tax  payers.  Being  a  tax  payer  himself  he  said  he  could  better  realize 
the  force  of  public  sentiment  in  this  direction. 

A  particular  description  of  the  main  poor-house  was  transmitted  to 
the  Legislature  in  1878,  Senate  Document  No.  19.  Few  changes  have 
taken  place  since,  except  in  the  outbuildings.  About  three  years  ago 
a  large  wood-shed  was  erected  near  the  insane  department.  During 
the  past  year  a  building  has  been  fitted  up  for  a  drying-room,  etc.  In 
this  is  a  large  refrigerator,  capable  of  storing  beef  in  carcass.  A  hog- 
house  has  also  been  added,  sixty  feet  by  twenty-four  feet.  An  inspec- 
tion was  made  of  the  various  departments  of  the  main  poor-house 
which,  as  in  former  visits  made  since  the  report  alluded  to  above, 
resulted  in  the  impression  that  the  same  cleanliness,  order  and  thrift 
prevailed,  which  have  so  long  marked  the  administration  of  the  present 
keeper. 

The  small  plot  in  front  of  the  premises,  with  its  flowers  and  shrubs, 
is  kept  by  the  matron,  Mrs.  Wood,  with  a  neatness  and  care  which 
make  it  one  of  the  pleasing  features  of  the  institution. 

The  visitation  was  made  by  Commissioner  Letchworth,  September 
7,  1881. 


32  Report  ox  the  Chronic  Insane. 

Chenango  County. 

The  poor-house  of  this  county  is  situated  six  miles  from  the  town 
of  Norwich,  aiul  luilf  a  mile  from  the  hamlet  of  Preston.  It  is 
reached  by  a  tedious  ride  over  steej)  hills.  The  site  is  elevated  and 
healtliy,  affording  a  good  water  supply  and  quick  drainage.  The  build- 
ing stands  about  live  rods  from  the  road. 

OfflciaU  and  employes. — The  administration  of  the  poor-house 
affairs  is  intrusted  to  a  board  of  three  su})erintendent8  of  the  poor, 
each  of  whom  receives  $2  per  day  for  actual  service,  and  $3 
per  day  when  transferring  the  acute  insane  to  Utica.  The 
keeper  of  the  poor-house  is  appointed  by  the  superintendent  of  the 
poor.  His  compensation  for  services  of  himself  and  wife  is  $500 
a  year  and  living,  §100  extra  being  allowed  to  pay  household  service. 
A  farm-hand  is  employed  at  l>17  per  month,  and  a  cook  at  $2 
per  week.  The  department  of  the  insane  is  under  the  charge  of  an 
asylum  keeper,  who  is  likewise  appointed  by  the  board  of  superintend- 
ents, and  who  receives  for  himself  and  wife  §500  per  year  and  living. 
He  is  permitted  to  hire  a  girl  a  few  weeks  during  the  season  of  house- 
cleaning  in  the  spring  and  fall.  There  are  no  paid  attendants,  nor  do 
sane  paupers  assist  in  this  department. 

Medical  supervision. — The  physician  to  the  poor-house  resides  at 
Preston.  He  visits  the  poor-house  weekly,  and  when  called,  charging 
for  each  visit  the  same  as  in  private  practice.  He  furnishes  his  own 
medicines,  except  in  cases  requiring  special  prescriptions.  The  medi- 
cines are  usually  given  to  the  keeper's  wife,  sometimes  to  the  keeper,  with 
instructions  to  dispense  them. 

A  monthly  register  of  the  condition  of  the  patients  is  kept  by  the 
keeper.  Occasionally  consulting  physicians  are  called.  The  medical 
profession  in  the  county  manifest  some  interest,  by  inquiries  about 
former  })atients,  and  sometimes  visiting  the  asylum. 

Buildings,  etc. —  The  main  building  of  the  poor-house  is  a  large 
wooden  structure,  painted  white,  with  shingled  roof,  in  which  re- 
side the  keeper's  family.  Here  are  also  the  dining-room  and  kitchen 
for  the  paupers.  On  the  right  is  a  two-story,  L-shaped  wing,  for  the 
women,  and  on  the  left  is  also  a  two-story,  L-shaped  wing,  with  base- 
ment, for  men.  To  the  rear  of  these  are  the  farm  buildings  with 
convenient  access  from  the  men's  quarters. 

The  asylum  department  is  located  about  thirty  feet  from  the  poor- 
house  building.  It  has  a  front  of  seventy-eight  by  thirty-two  feet 
deep;  is  two  stories  high,  with  attic,  cellar  and  basement.  The  cellar 
is  used  for  the  storage  of  coal,  wood,  vegetables  and  farm  ])roduct8, 
the  basement  as  a  kitchen  and  wash-room.  In  rear  of  this  is  a 
two-story  wing,  twenty-nine  by  thirty-one  feet ;  at  the  end  of  the  main 
structure  is  another  wing,  sixteen  by  thirteen  feet,  one  story  in  height. 
On  the  first  floor,  at  entrance,  are  three  apartments.  The  first  of  these 
is  an  office,  the  second,  the  family  room  of  the  asylum  kcei)er,  and  the 
third,  his  bedroom.  Beyond  this  is  a  dining-room  for  inmates;  the 
rear  end  being  used  for  the  keeper's  kitchen,  and  several  small  rooms 
on  one  side,  occupied  by  patients.  Beyond  this  is  a  hall,  with  rooms 
on  each  side  for  patients,  and  in  the  adjoining  building  is  also  a  hall, 
with  smaller  rooms;  all  rooms  below  stairs  being  used  for  women. 
The  second  floors  are  similarly  planned  and  used  as  wards  for  patients. 


Report  on  the  Chronic  Insane.  33 

In  the  attic,  some  small  rooms  have  been  recently  finished,  to  accom- 
modate the  increasing  nnmber  ot  inmates.  Tlie  ward  occupied  by  the 
women,  off  the  dining-room,  consists  of  a  hall,  thirty-two  feet  long  by 
eleven  wide,  with  two  large  windows  at  one  end.  There  are  three 
rooms  on  each  side  of  this  hall.  The  windows  are  furnished  with 
white  muslin  curtains,  having  scarlet  border  and  fancy  bows.  The 
floor  is  of  maple;  the  room  was  furnislied  with  table,  two  strong 
chairs  (used  as  restraining  chairs)  seA^eral  arm  chairs,  Windsor  chairs 
and  rocking  chairs.  The  first  room  on  the  right  measures  nine  and 
one-half  by  ten  feet.  The  windows  are  double  sash,  twelve  lights, 
nine  by  fourteen,  and  sash  bolts  There  are  no  gratings  nor  bars.  The 
window  has  green  outside  blinds.  The  room  has  a  panel  door,  trian- 
gular transom  above  it,  and  bare  floor.  It  is  ceiled  throughout,  was 
occupied  by  a  paying  patient,  and  contained  a  variety  of  furniture. 
This  description,  excepting  as  regards  furniture,  answers  for  the  three 
rooms  on  ihe  front  side. 

Tlie  room  adjoining  is  used  for  the  double  purpose  of  bed-room  and 
bath-room.  It  contained  a  bath-tub  and  cold-water  pipes,  hot  water 
being  brought  in  pails.  The  window  was  curtained  ;  a  plain  rug  lay 
on  the  floor.  The  next  room  was  used  for  a  clothes-press  and  store- 
room, in  which  the  clothes  were  neatly  folded  and  the  patients'  dresses 
hung  on  the  walls.  The  rooms  on  the  left  averaged  in  size  about 
seven  and  a  half  by  nine  feet.  They  are  ceiled  throughout,  have  win- 
dows, six  lights,  nine  by  sixteen,  protected  by  wire  screens.  The 
doors  of  these  rooms  extend  from  floor  to  ceiling,  and  are  made  of 
frame-work,  two  by  three  inch  studding;  the  interior  space  horizon- 
tally and  vertically  latticed,  with  one  by  three-inch  slats.  These  had 
an  opening  in  the  center.  The  doors  were  secured  by  hasp  and  padlock. 
A  water-closet  on  this  floor  is  provided  with  two  seats  and  supplied 
with  running  water. 

The  hall. in  the  lower  part  of  the  rear  is  nine  and  a  half  by  twenty- 
seven  feet,  with  two  windows  at  one  end  having  wire  screen  inside. 
Stationary  benches  are  placed  against  the  wall  on  one  side.  The  stove 
is  in  the  center  of  the  hall ;  a  sink  occupies  one  end,  with  pail,  basin 
and  towels. 

Six  women  were  in  this  hall  ;  one  was  reading  a  book,  two  sitting 
in  chairs,  one- sitting  on  the  floor,  others  walking  or  standing.  This 
floor  is  provided  with  water-closet, and  running  water;  the  room  doors 
on  one  side  are  latticed  as  described,  and  the  opposite  side  paneled 
with  transoms.  The  first  is  secured  by  hasp  and  padlock.  Some 
rooms  are  wainscoted  about  four  feet,  and  plastered  above  ;  others  are 
ceiled  throughout.  The  rooms  are  painted  in  various  colors. 
Windows  are  protected  by  wire  screen  work.  These  rooms,  as  was 
generally  the  case  throughout  the  house,  were  furnished  with  bed  and 
night  vessel.  In  a  few  instances  other  simple  articles  of  furniture 
were  included.  The  ward  had  several  rooms,  uniform  in  character ; 
it  was  occupied  mostly  by  men.  One  of  the  rooms  had  a  stationary 
bunk, occupied,  it  was  said,  by  a  "  wild  Irishman,  afflicted  with  a  pro- 
pensity to  kick,  tear  and  thrash  around."  The  windows  are  protected 
by  iron  gratings.  This  ward  is  likewise  provided  with  a  water-closet. 
One  of  the  rooms  was  occupied  by  a  woman,  who  was  provided  with 
straw  bed  and  bedstead,  upon  which  she  sat  in  a  crouched  position; 
she  was  said  to  be  very  filthy,  and  destructive  of  clothing.     In  the 


34  Report  on  the  Chronic  Insane. 

room  was  a  strong  cliair  in  which  she  was  occfisionally  fastened.  The 
windows  are  close  grated 

In  anotlier  room  was  kept  a  woman  wlio  at  the  time  of  visit  was 
working  in  the  kitclien.  The  kee])er  said  :  ''  Once  in  four  or  6ve  weeks 
she  is  subject  to  paroxysms  of  excitement,  wiiich  will  last  two  or  three 
weeks,  followed  by  a  week's  sleep  and  napiiing,  after  which  she 
becomes  useful  in  the  industrial  department."  Two  men  were  here 
pacing  up  and  down  the  hall. 

The  upper  ward,  over  that  first  described,  contains  the  same  number 
of  rooms  and  is  similar  in  description  ;  it  is  a  ward  for  males.  Two 
of  the  rooms,  however,  are  occupied  by  women,  who  the  keeper  said 
*•  went  to  their  rooms  after  the  men  had  gone  to  bed." 

The  ward  in  the  dining-room  has  rooms  on  one  side  and  end,  eight 
in  all,  with  five  grated  windows  lighting  the  hall  space ;  it  contained  a 
stove  and  a  large  spittoon  ;  the  floor  was  painted.  There  were  eight 
male  patients  in  the  hall,  one  wearing  a  camisole,  another  was  seen 
fastened  in  a  cliair  with  belt  strap,  and  further  restrained  by  means  of 
a  muff  and  iron  shackles  —  the  latter  being  fastened  by  a  strap  passed 
through  a  staple  in  tiie  floor.  Six  of  the  small  rooms  have  paneled 
doors,  two  are  made  of  strong  studs  with  opening  in  center,  and  fast- 
ened with  hasp  and  padlock;  tlie  windows  of  the  rooms  are  small  and 
all  protected  by  gratings,  except  one,  whicii  has  a  wire  screen.  One 
of  the  rooms  had  a  double  bedstead,  of  which  there  were  several  in  the 
asylum;  this  was  used  by  two  patients,  one  of  them  at  the  time  was 
lying  in  bed,  the  other  was  in  the  hall. 

One  of  the  rooms,  the  door  of  which  was  unfastened,  was  occupied 
by  a  strong  and  healthy  woman,  said  to  be  about  sixty  yenrs  of  age, 
who  was  lying  in  bed  at  the  time. 

The  reason  given  for  non-observance  of  strict  separation  of  the 
sexes  was:  "  a  preponderance  of  women,''  and  it  was  added  that  *'  the 
classification  as  to  quiet  and  disturbed  cases  was  the  dominant  idea." 
In  the  attic,  over  the  front  building,  is  a  long  central  hall,  extending 
throughout  half  the  building,  lighted  by  a  window  at  the  end.  On 
the  sides  of  this  hall  are  eleven  rooms.  The  two  end  rooms  have  each 
a  window.  The  others  are  lighted  and  ventilated  by  latticed  doors. 
They  are  painted  in  various  colors,  and  their  average  size  is  seven 
feet  three  inches  by  eight  feet,  with  average  ceilings.  The  doors  are 
secured  by  hasp  and  padlock.  The  rooms,  only  five  qf  which  were 
occupied,  were  furnished  with  bedstead,  bed,  and  night  vessel.  The 
yard  for  men  and  women  is  inclosed  by  a  white  painted  picket  fence, 
six  feet  high,  about  twenty-eight  wide  and  thirty-seven  long. 

Heating  (uid  ventilation, —  The  buildiug  is  warmed  by  stoves,  cen- 
trally placed  in  the  various  wards.  The  windows  are  mainly  relied 
upon  for  ventilation. 

Dijiing-rooni  and  food. —  In  the  dining-room  at  time  of  visit, 
the  table  was  being  set  and  breakfast  i)repared  by  the  keeper  and  his 
wife.  Two  insane  women  and  a  "liiredgirl"  assisted.  The  latter 
had  been  employed  to  assist  through  the  fall  house-cleaning.  The 
windows  of  the  room  had  tasteful  muslin  curtains,  and  on  the  wall 
hung  a  small  looking  glass.  At  the  end.  adjoining  the  keeper's  apart- 
ments, was  a  small  cook-stove,  sink,  and  various  kitchen  utensils. 
Partitioned  off  the  dining-room  on  one  side  is  a  small  sleeping-room  ; 
also  two  cells  with  doors  made  of  three  by  four-inch  framed  scantling 


Report  on  the  Chronic  Insane.  35 

with  a  central  aperture  for  passing  iu  food,  secured  by  hasp  and 
padlock.  The  windows  were  sixliglit,  seven  by  nine,  grated  witli  rods 
about  three  and  a  half  inches  apart.  These  have  transoms  over  the 
door  about  six  by  twenty-four  inches. 

Dishes  were  placed  for  thirty-nine  persons.  Twenty-seven  women 
and  twelve  men  were  seated  at  the  two  long  tables.  Windsor  chairs 
with  bent  rails  were  in  use.  Crockery  plates,  cups  and  saucers  were 
placed  for  all,  except  seven.  These  had  tin  basins  instead,  also  spoons. 
The  tables  were  supplied  with  salt  in  tea  cups ;  tin  pepper  boxes,  also 
a  large  bowl  of  milk.     A^o  table  cloths  were  in  use. 

The  breakfast  consisted  of  fried  pork,  a  slice  of  which  was  laid  on 
each  plate,  butter,  boiled  potatoes,  large  slice  of  bread  to  each, 
nnsweetened  tea,  with  or  without  milk,  as  desired.  One  drank  water. 
Two  meals  are  regularly  furnished  throughout  the  year,  excepting  to 
those  who  work.  They  are  provided  with  an  extra  mid-day  meal  in 
the  kitchen.     All  the  bread  for  the  insane  is  baked  in  the  poor-house. 

Breakfast  is  served  at  9  o'clock,  a.  m.,  and  dinner  at  4  p.  m.  The 
former  is  given  as  follows  :  Meat,  pork  or  beef,  and  potatoes,  bread  and 
butter,  unsweetened  tea;  sometimes  codfish  picked  and  cooked  in  milk 
is  supplied,  also  Mackinaw  trout,  fried  or  baked;  sometimes  are  added 
cookies  or  fried  cakes.  Four  o'clock,  dinner.  This  meal  was  described 
by  the  keeper,  as  in  farmer  phrase,  a  "  boiled  dinner,"  and  consists  of 
the  following:  Corn,  beets,  turnips,  onions,  green  peas,  and  other 
vegetables  in  summer;  baked  beans  and  soup  occasionally,  but  no  but- 
ter; sometimes  pudding,  milk  and  potatoes  warmed  up.  Plain  tea  is 
allowed  at  the  latter  meal,  sometimes  pickles  or  pickled  beets. 

Clothing. — The  summer  clothing  of  the  men  was  said  to  be  a  cotton 
shirt,  cottonade  j^ants  and  coat,  while  some  wear  vests.  A  portion  of 
the  inmates  have  stockings,  some  shoes  or  slippers,  while  those  who  go 
out  to  do  chores  wear  boots.  In  winter  woolen  clothes  are  worn,  cot- 
ton shirt,  no  undershirt  nor  drawers.  About  one-half  wear  woolen  and 
the  other  half  cotton  stockings  with  slippers,  shoes  and  boots.  No 
overcoats,  it  was  said,  are  required  for  the  men  who  do  chores,  as  they 
are  not  exposed.  The  dress  of  the  women  is  calico  or  denim,  cotton 
chemise  and  drawers  ;  some  wear  uuder-wrappers  and  canton-flannel 
or  woolen  skirts,  cotton  stockings,  shoes  or  slippers.  All  wear  drawers, 
except  one  or  two.  Either  hats  or  hoods  are  worn.  In  summer,  cotton 
are  substituted  for  woolen  skirts' with  no  under-wrapper. 

Bedding. — The  bedsteads  in  use  are  mostly  of  wood,  after  the  Wil- 
lard  asylum  pattern,  with  iron-strapped  bottom.  Tlie  bedding  con- 
sists of  a  straw  tick,  to  which,  for  those  who  are  cleanly  in  habits,  a 
feather  bed  is  added;  feather  pillows,  two  sheets,  and  one  or  more  bed- 
quilts  are  used,  according  to  the  season. 

Em2)loyment. — The  total  number  of  inmates  in  the  insane  depart- 
ment is  forty-one,  fourteen  of  whom  are  men  and  twenty-seven 
women.  There  are  but  two  men  who  go  out  of  the  asylum  to  work. 
These  "do  chores,"  saw  wood,  and  wait  on  the  kitchen.  There  are 
two  of  the  men  who  work  in-doors,  sweeping  and  assisting  in  house- 
work. The  women,  of  whom  there  are  five,  are  employed  Avithin 
doors  at  general  housework. 

It  is  thought  that  none  of  the  men  perform  a  fair  day's  labor,  and 
the  four  doing  a  partial  day's  work  are  not  worth  the  services  of  a  paid 
man.     The  labor  of  the  women  is  thought  to  be  equal  in  service  to  that 


36  Report  on  the  Chronic  Insane. 

of  a  '•  hired  girl."'  The  women  work  under  the  direction  of  the 
keeper's  wife.  None  of  tlieni  are  disposed  to  overwork.  Both  the 
keei)er  and  i)liysician  think  they  are  better  if  tliey  have  something  to 
do.  In  the  kitchen,  at  the  time  of  visit,  six  women  were  variously 
em])loyed.  One  was  ])aring  potatoes,  others  washing;  one  woman  was 
sitting,  while  scrubbing  clothes  at  a  wash-tub.  She  was  very  stout. 
Her  weight  hud  been  ascertained  during  the  year  to  be  three  hundred 
and  forty-seven  pounds. 

Resfraiiif. —  The  door  leading  to  the  yard  is  generally  unlocked,  and 
it  is  said  a  great  portion  of  the  patients  have  the  range  of  the  wards, 
dining-room  and  kitchen.  The  quieter  cases  are  permitted  to  walk  in 
the  ])our-liouse  grounds.  U'he  keeper  said,  he  aimed  at  giving  them  as 
much  freedom  as  possil)le;  they  had,  he  said,  the  same  liberty  which 
they  would  enjoy  in  their  own  homes.  While  no  attempts  at  escape 
were  made,  yet  the  keeper  believes  that  many  might  get  away  if  they 
thought  it  possible.  At  the  time  of  visit  but  two  persons  were 
locked  up,  one  in  the  hall,  and  a  woman  in  her  own  room.  Two 
darkened  cells  or  rooms  were  occupied  by  two  women,  but  only  as 
sleeping-rooms  at  night.  Punishment  of  the  insane  is  never  resorted 
to,  the  keeper  said,  "  except  it  be  the  locking  up  in  rooms  for  a  short 
time." 

Far?}!  and  garden. —  The  poor-house  farm  comprises  one  hundred 
and  seventy  acres,  on  which  twenty-three  cows  are  kept,  the  products 
are  consumed  on  the  premises;  a  good  many  potatoes  are  raised,  as 
well  as  some  wheat,  oats,  and  a  little  corn. 

Water  supply. —  Water  is  supplied  to  the  institution  from  a  spring, 
distant  about  one  hundred  and  seventy  rods  ;  it  is  conducted  twenty 
rods  of  the  distance  by  two-inch  pipe,  thereafter  reduced  to  one  and  a 
half  inch  for  some  little  distance,  and  the  remainder  one-inch  pipe. 
The  supply,  it  is  said,  has  been  sufficient  during  the  past  summer,  but 
is  not  in  excess  of  needs. 

Seioerage. —  The  water-closets  are  drained,  as  are  likewise  the  kitchen 
slops,  into  a  stone  vault  a  short  distance  from  the  house,  and  thence 
conducted  in  a  stone  drain,  rapidly  descending  to  the  fields,  a  goodly 
distance  from  the  buildings. 

Ge7ieral  oliservations. —  The  acute  insane  are  received  into  the 
institution,  but  it  is  said  they  are  promptly  transferred  to  Utica.  It 
would  a])pear  that  there  is  a  good  deal  of  visiting  by  pleasure  seekers. 
It  is  thought  that  the  visits  made  in  summer  average  forty  per  week  ; 
Some  of  these  are  by  interested  citizens,  but  most  are  out  of  curiosity 
or  from  pleasure;  the  physicians  think  there  is  too  much  of  this.  In 
some  of  the  apartments  much  confusion  was  manifest  in  consequence 
of  a  vigorous  house-cleaning  which  was  going  on.  A  careful  examina- 
tion left  the  impression  that  cleanliness  and  good  house-keeping  pre- 
vailed in  the  administration  of  the  establishment. 

The  visitation  was  made  by  Commissioner  Letchworth,  November 
4,  1881. 

Cortland  County. 

The  poor-house  of  Cortland  county  is  about  two  miles  from  the  vil- 
lage of  Homer  and  two  and  a  half  miles  from  Cortland  village,  wliich 
is  the  post  office-address.     'It  is  also  within  a  quarter  of  a  mile   of 


Eeport  on  the  Chronic  Insane.  37 

Loring,  a  flag  station  ou  the  Ithaca  and  Elmira  raih'oad.  It  is  situ- 
ated in  a  small  valley  on  the  banks  of  the  east  branch  of  the  Tiough- 
nioga,  a  clear,  rapid  flowing  stream. 

Officials  and  employes. —  This  county  has  one  superintendent  of 
the  poor,  George  Murray,  senior,  who  resides  at  Homer.  His  compen- 
sation is  S500  per  annum.  He  succeeds,  by  an  appointment  of  the 
board  of  supervisors,  to  the  place  of  Silas  Blanchard,  who  died  July  10, 
1881.  Mr.  Blanchard,  by  his  careful  and  conscientious  administration 
of  the  poor-house  of  this  county,  had  won  an  enviable  reputation  and 
enjoyed  the  confidence  of  both  political  parties,  and  the  universal  re- 
spect of  the  people  of  the  county.  He  held  the  position  of  superinten- 
dent for  eleven  years. 

The  keeper  of  the  poor-house,  Alonzo  W.  Gates,  who  has  held  the 
position  for  seventeen  years,  is  appointed  by  the  superintendent.  His 
salary,  including  that  of  his  wife,  who  acts  as  matron,  is  $550  per 
year  and  living.  The  compensation  of  the  subordinates  is  fixed  by 
the  superintendent.  A  farmer  is  employed  on  the  farm.  The  insane 
department  is  in  charge  of  a  sub-keeper  and  wife,  who  receive  jointly 
1360  per  annum  and  living.  Their  sleeping  apartments  are  in  the 
building  with  the  insane.  There  are  no  other  paid  attendants,  nor 
are  paupers  in  care  of  the  insane.  "If  assistance  is  wanted,"  it  is  said, 
"  the  farmer  is  called  in." 

Medical  supervision. —  The  physician,  S.  C.  "Webb,  M.  D.,  resides 
at  Homer  village.  He  is  appointed  by  the  superintendent,  is  required 
to  visit  every  other  day,  and  oftener  if  occasion  demands.  His  salary 
is  8200  per  year.  All  medicines  are  supplied  by  the  county.  No  pay 
is  allowed  for  extra  services  or  surgical  operations.  Medicines  are  dis- 
pensed by  the  physician,  or  by  the  keeper  of  the  insane  department 
under  his  direction. 

There  are  no  consulting  physicians.  In  special  cases  counsel  is 
called.  The  medical  profession,  the  physician  says,  "  visit  the  insti- 
tution occasionally  and  enquire  after  cases  with  which  they  are  famil- 
iar. A  favorable  disposition  is  manifested  by  physicians  throughout 
the  county  toward  the  institution."  "  Citizens  frequently  inquire  and 
make  visits  to  the  house ;  some  of  course  are  mere  curiosity  seekers, 
others  prominent  citizens.  Supervisors  manifest  a  personal  interest 
by  occasional  visits." 

The  insane  are  registered  in  the  poor-house,  A  copy  of  the  same  is 
filed  with  the  county  clerk.  The  form  is  that  prescribed  by  the  State 
Commissioner  in  Lunacy.  The  certificates  mostly  show  whether  the 
case  is  acute  or  chronic. 

General  description. —  The  jooor-house  is  a  two-story  brick  structure 
with  slate  roof.  The  central  portion  is  used  for  the  keeper's  family, 
office,  kitchen,  etc.  The  right  and  left  wings  are  for  inmates.  The 
basement  cellar  is  used  for  milk-room,  storage,  etc.  In  the  rear  of  the 
poor-house  building,  twenty  eight  feet  distant,  stands  the  department 
for  the  insane,  in  which  there  were  twenty-nine  patients.  This  build- 
ing consists  of  a  central  portion  of  brick,  to  which  is  attached  a 
wooden  building,  fifty-one  feet  long,  and  thirty-one  feet  wide,  under 
which  there  is  no  cellar.  In  rear  are  the  yards  for  both  sexes  of 
the  insane.  In  the  central  port'on  on  the  first  floor  are  the  rooms 
of  the  keeper  and  his  wife,  kitchen  and  two  dining-rooms,  one  for 
men  and  one   for   women.     These  communicate  with  the  men's  ward 


38  Report  ox  the  Chronic  Insane. 

on  the  left  and  the  Women's  on  the  right.  Above  are  dormitories,  one 
for  men  and  one  for  women.  In  the  rear  structure  the  partition  ex- 
tends through  the  center,  dividing  the  men's  from  the  women's  wards. 
Througli  tlie  men's  ward  on  the  lower  floor  is  a  Inill,  ten  feet  wide, 
twenty-four  feet  long,  with  ten  foot  ceiling.  On  each  side  of  this  are 
small  rooms.  There  are  stationary  benches  on  the  sides  of  the  room. 
Above  the  doors  of  the  small  rooms  are  transoms,  twelve  by  twenty- 
six  inches,  grated.  One  of  the  rooms  measured  was  seven  feet  by  five 
feet  two,  and  had  ten  foot  ceiling;  another,  six  feet  by  seven  ;  another 
seven  feet  four  by  seven  feet.  The  windows  have  double  sash,  six 
lights,  eight  by  twelve,  outside  vertical  iron  gratings,  half-inch  rods, 
with  three  and  a  half  inch  spaces.  Oneof  tlie  rooms  on  the  first  floor 
in  the  men's  ward  is  ceiled  ;  the  windows  are  protected  by  iron  grat- 
ing on  the  inside  and  also  a  wire  screen.  Tiie  room  was  occupied  by 
a  suicidal  case  who  had  tried  to  hang  himself.  The  door  of  this  room 
was  secured  l)y  hasp  and  padlock.  The  windows  in  this  ward  have 
iron  guards  or  gratings  outside.  Another  room  on  this  floor  has 
ceiled  sides,  inside  grating,  and  was  said  to  be  used  by  patients  who, 
for  a  few  hours  at  a  "time,  were  under  paroxysms  of  excitement.  The 
ward  above  is  similar  to  that  below,  with  stationary  benches  at- 
tached to  the  side  spaces  of  the  hall.  A  few  colored  prints  were  on 
the  wall,  also  a  looking  glass.  Opening  out  of  this  ward  are  six  small 
rooms  with  plastered  walls.  These  average  six  by  seven  feet  and  in- 
clude a  clothes-press.  One  of  these  rooms  was  occupied  by  a  patient 
who  formerly  was  an  inmate  of  one  of  the  obsolete  dungeons  of  the 
Onondaga  county  poor-house. 

The  description  of  the  rooms  and  wards  for  men  will  answer  for  the 
upper  and  lower  wards  for  women  at  the  opposite  end  of  the  building. 
The  walls  have  a  few  framed  pictures  and  some  a  looking  glass.  The 
rooms  were  generally  unfurnished,  except  as  to  a  bed  and  night  vessel. 
In  some  was  a  seat,  a  small  carpet  rug,  a  few  trinkets  and  wall  ornaments. 
On  the  inside  casings  of  one  of  the  rooms,  by  means  of  a  pin,  a  patient 
had  punctured  the  wall  daily,  thereby  showing  a  record  of  her  incar- 
ceration. At  one  point  was  noted  the  number  of  "days  from  home," 
another,  '•  two  years  in  here."  Here  was  also  punctured  the  date  of 
her  transfer  from  the  Onondaga  county  poor-house.  This  room  had 
a  few  cheap  prints  on  the  walls  (the  frames  made  by  the  i)atient)  some 
dried  grasses,  a  few  trinkets  and  ornaments.  Several  dresses,  tidily 
kept,  hung  on  the  wall,  the  room  showing  the  neatness  and  taste  of 
its  occupant. 

On  the  south  and  west  sides  of  the  women's  department  were  win- 
dow awnings.  In  the  associated  dormitory  for  women,  over  the 
dining-room,  considerable  taste  was  shown  in  decorating  the  apart- 
ment, and  a  preference  for  bright  colors.  Kugs  were  before  nearly  all 
the  beds  ;  one  was  a  fancy  patch-work.  All  of  the  beds,  excepting 
one,  had  fancy  patcli-work  quilts  made  by  the  patients.  In  the  room 
were  two  tasteful  crosses,  made  of  green  arbor  vita^and  myrtle,  briglit- 
ened  with  red  mountain  asli  berries,  coxcomb  and  thorn  apples.  Here 
were  also  ornamental  hanging  shelves  and  evergreen  wreaths  made  by 
one  of  the  patients.  There  were  also  framed  pictures  on  the  walls  and 
stand,  on  which  were  sundry  trinkets,  including  a  little  ])aper  cradle. 

The  men's  dormitory  corresponds  in  size  to  that  of  the  women's, 
being  eleven  feet  by  twenty,  with  seven  feet  four  inch  ceilings.     It 


Report  o]S!  the  Chronic  Ii^tsane.  39 

contained  six  beds.  The  windows  are  of  uniform  size,  with  outside 
gratings.  The  stairs  in  this  building  are  so  located  as  to  afford  ready 
egress  in  case  of  fire.  In  the  women's  ward  was  a  patient  suffering 
from  mania  caused  by  religious  excitement.     She  was  singing  hymns. 

The  door  opening  into  the  women's  yard  was  unlocked,  affording 
free  access  thereto.  It  is  long  and  narrow,  being  twenty-three  feet  by 
eighty,  fenced  with  rough  boards,  twelve  feet  high.  In  the  center 
was  a  square  pavilion,  ten  by  twelve  feet,  with  a  double  seat  extending 
through  it.  A  path  was  worn  in  the  grass  around  the  borders  of  the 
yard.  The  water-closet  has  a  cemented  vault,  sawdust  and  ashes  be- 
ing used  for  deodorization.     It  was  said  to  be  ''cleaned  twice  a  year." 

The  men's  yard  is  thirty  feet  wide,  of  the  same  length,  sanded  in- 
stead of  grassed,  with  pavilion  and  closet  as  in  the  women's  yard. 

The  door  to  the  yard  was  likewise  open  ;  there  were  five  men  in  the 
yard  and  eight  in  the  hall. 

A  one  and  a  half  story  building,  twenty-two  by  fifty  feet,  stands 
about  twenty-five  feet  from  the  asylum  building  and  is  separated  by  a 
fence.  A  central  hall  and  stairway  separate  the  building  into  two  di- 
visions, the  right  being  used  for  women,  the  left  for  men.  In  the 
male  department  was  an  idiot  boy  of  sixteen  in  care  of  an  adult  pau- 
per. In  the  corner  a  strong  room  was  partitioned  off  for  turbulent 
cases,  said  to  be  seldom  used.     The  room  contained  four  beds. 

In  the  women's  department  were  several  idiot  patients  in  charge  of 
two  pauper  women.  The  room  contained  three  beds.  Both  depart- 
ments were  well  warmed  and  in  apparent  good  order.  There  is  also  a 
strong  room  in  the  women's  department.  A  room  above  was  used  for 
sleeping,  another  for  storage,  another  as  a  drying-room.  At  each  end 
of  the  building  is  a  small  yard  eight  paces  in  width  by  nine  in  length, 
with  water-closet.  This  building  is  used  to  isolate  the  idiotic  and 
filthy  cases. 

The  house  was  kept  in  clean  and  orderly  condition.* 

A.  number  of  the  insane  men  and  women  were  kept  in  the  poor- 
house  building  with  the  sane.  It  was  said: "  They  sleep  in  associated  dor- 
mitories with  paupers  in  the  poor-house  department,  eat  at  the  pau- 
pers' table,  have  the  same  care,  and  share  the  same  freedom  as  the  sane 
paupers. " 

Laundry, — The  washing  of  clothes  for  the  insane  is  done  in  the  poor- 
house  department  on  a  day  set  apart  for  the  purpose  ;  the  work  is 
performed  by  the  patients,  under  the  supervision  of  the  asylum  keeper 
or  his  wife. 

Bathing. — A  small  hall  leading  to  the  yards  was  likewise  used  as  a 
bath-room  and  contained  a  bath-tub,  water  being  supplied  from  a  pump. 
Hot  water  was  brought  in  pails. 

Heating  and  ventilation. — The  men's  ward,  lower  floor,  is  heated  by  a 
coal  stove  in  the  hall,  protected  by  iron  gratings  and  secured  by  pad- 
lock. The  hall  above  has  a  grated  space  in  the  ceiling  to  the  attic  for 
the  purpose  of  ventilation.  The  ceiling  of  the  lower  ward  has  an  open- 
ing to  warm  the  ward  above.  In  the  walls  of  the  halls  are  ventilating  flues. 
The  atmosphere  was  somewhat  impure.  The  rooms  have  window  ventila- 
tion only. 

The  men  and  women's  associate  dormitories  are  ventilated  by  means 
of  a  tin  tube  extending  through  the  roof. 

Dining-room  and  food.  —  At   the  date  of    visit,    dinner  was  be- 

6 


40  Report  on  the  Chronic  Insane. 

ing  prepared  and  the  table  set  by  the  keeper's  wife,  aided  by  four  or 
tivc  insane  women.  The  tables  were  covered  with  enameled  cloth.  A 
small  table  was  being  prepared  with  food  to  be  carried  into  the  wards  for 
two  epileptic  patients  ;  one  of  them  a  man  weighing  two  hundred  and 
twenty-six  pounds.  The  table  was  laid  with  crockery  plates,  bowls 
and  pitchers,  steel  knives  and  forks,  salt  cellar  and  pepper  boxes. 
Round  top  stools  were  used  for  seats.  The  dinner  consisted  of  a  meat 
and  potato  stew,  bread,  pickled  beets,  and  cabbage  with  vinegar,  and  gin- 
ger cookies.  Milk  was  on  the  table  for  those  who  desired  it.  All  who 
preferred  tea  were  served  Avith  it.  The  women's  dinner  and  table 
were  similar.  All  were  eating  at  the  tables,  except  three  ;  one  being 
an  epileptic,  who  with  two  others  was  served  in  the  wards.  One  re- 
quired to  be  fed  with  a  spoon. 

There  were  a  few  pictures  on  the  walls  in  the  dining-rooms.  The 
doors  between  the  two  rooms  were  open  and  the  keeper  and  his  wife 
served  the  meal.  The  keeper  gave  the  dietary  as  follows  :  "  We  always 
have  three  meals  a  day.  For  breakfast  :  meat  and  potatoes,  either 
boiled  or  baked  —  the  meat  is  oftener  pork  than  beef, — bread,  tea, 
generally  flour  gravy,  pickles.  We  always  have  milk  on  the  table  and 
they  can  help  themselves  to  it.  We  always  have  vegetables.  For  din- 
ner: bread  and  butter,  tea  and  milk,  generally  pickles.  Have  four 
meals  of  a  week,  some  days  fish  ;  beef  served  in  a  variety  of  ways, 
sometimes  in  the  form  of  a  pot-pie.  For  supper  :  bread  or  biscuit  and 
butter,  sauce,  cake  or  pie,  or  pudding  of  some  kind  ;  also  tea  and  milk. 
In  the  fruit  season  we  have  baked  apples,  red  raspberries,  blackber- 
ries and  this  summer  strawberries,  tomatoes  in  their  season,  occasionally 
grapes,  melons  and  peaches.  Once  a  week  we  have  a  meal  of  mush  and 
milk,  or  johnny-cake  and  milk,  or  bread  and  milk.  With  this  meal  is 
furnished  butter.  We  always  have  butter  twice  aday  and  sometimes  in 
hot  weather  three  times  a  day.  To  avoid  waste,  bread  is  sliced  from 
the  loaf  as  wanted."  It  appeared  that  the  food  was  abundant  and  of 
great  variety.  The  bread  for  the  asylum  is  baked  in  the  poor-house 
department. 

Clothing. —  The  clothing  of  the  men  when  within  doors  was  given 
as  follows  :  cotton  shirt,  a  few  with  cotton  under-shirt,  lined  woolen 
pants,  woolen  coat  and  vest,  cotton  and  woolen  socks,  shoes  or  boots, 
felt  hat.  In  winter  those  who  work  outside  have  thick  flannel  under- 
shirts, knit  woolen  drawers,  boots,  mittens  and  overcoats.  All  the 
Avoolen  socks  used  are  made  from  wool  of  the  sheep  raised  on  the  farm, 
spun  and  knitted  in  the  institution.  Some  fulled  cloth  is  made  from 
yarn  spun  and  woven  in  the  house,  from  which  garments  are  made 
under  direction  of  the  keeper's  wife,  aided  by  pauper  labor. 

The  dress  for  women  in  winter  vvas  given  as  follows:  Those  less  able 
to  take  care  of  themselves  have  woolen  dresses  of  strong  home-made 
cloth  ;  others  of  calico.  All  have  woolen-flannel  under-skirts  and  canton- 
flannel  Avrappers  in  winter,  Avith  cotton  under-wear  and  cotton  stock- 
ings as  well  as  shoes  in  summer. 

Bedding. — The  bedsteads  are  of  wood,  after  the  style  of  the  Wil- 
lard  asylum,  iron  strap  bottom  ;  the  bed  consists  of  a  tick  filled  with 
straw,  feather  bed,  feather  pillow,  two  sheets,  quilt.  It  was  said,  "all 
have  feather  beds  if  neat  in  their  habits."  Additional  covering  is 
used  in  winter. 

Enwloyment. —  In  summer  some  of  the  men  are  employed  at  com- 


Report  on  the  Oheonic  Insane.  41 

mon  farm  work,  although  this  work  is  not  continuous,  and  there  is  no 
employment  for  them  in-doors. 

The  women  do  sewing  and  the  housework  of  the  asylum.  Nine  of 
the  men  and  five  women  perform  a  partial  day's  labor ;  of  the  women 
four  perform  a  fair  day's  work.  There  are  no  special  work-rooms  for 
the  sexes.  As  to  the  value  of  the  men's  labor,  the  keeper  said: 
*' There  are  none  tliat  I  would  take  and  pay  board  for;  it  is  true  they 
labor,  but  it  is  all  that  the  work  is  worth  to  get  it.  The  patients  are 
never  urged  to  work  beyond  their  ability,  and  there  is  little  disposition 
to  do  so.  In  one  case  a  female  was  restricted  when  disposed  to  over 
work." 

Restraint. — In  the  women's  upper  ward  is  a  crib,  made  of  wooden 
slats,  with  lid  secured  by  hasp  and  padlock.  At  the  time  of  visit, 
none  of  either  sex  were  locked  in  their  rooms.  In  the  women's  de- 
partment was  a  strong  arm  chair,  varnished,  and  used  for  restraining 
chair,  though  not  occupied.  There  are  also  two  strong  arm  chairs, 
used  as  restraining  chairs,  with  strap  around  waist,  as  well  as  wristlets 
and  anklets;  three  muffs,  and  three  pairs  of  handcuffs.  Eestraint 
was  said  to  be  used,  but  only  to  a  small  extent.  In  important  cases, 
the  keeper  is  consulted.  The  attendant  exercises  his  judgment,  and 
afterward  notifies  the  keeper.  One  case,  that  of  a  male  epileptic,  was 
handcuffed  constantly,  except  during  night.  There  is  no  special  pro- 
vision for  epileptics. 

Amusemeiits,  etc. —  Some  reading  matter  is  brought  by  the  physician 
every  week,  consisting  of  the'  ordinary  newspaper  exchanges.  No 
in-door  nor  out-door  amusements  are  provided. 

Water  supply. —  The  water  is  brought  from  a  hillside  spring,"  eighty 
or  one  hundred  rods  distant,  Avith  one  hundred  feet  elevation.  For  a 
few  rods  from  the  spring,  the  water  is  conveyed  in  one-inch  iron  pipe; 
thence  to  the  house  in  a  three-quarter-inch  lead  pipe.  It  is  said  the  spring 
never  fails,  although  in  dry  times  the  pipes  are  not  entirely  filled. 

Wells  are  "  driven"  about  the  premises  for  drinking  water,  there 
being  four  at  the  poor-house  building,  three  at  the  asylum,  and 
one  at  the  barns.  Eain  water  is  not  utilized.  The  stream  already 
referred  to  is  about  twenty  rods  from  the  asylum  building. 

A  hand  force  pump,  and  about  one  hundred  feet  of  one-inch  rub- 
ber hose  is  provided,  as  protection  against  fire. 

Seiuerage. — A  main  sewer  one  foot  in  diameter  of  round  socket-tile, 
cemented,  extends  from  the  wash-house  and  kitchen  through  the  west 
wing,  about  one  hundred  feet,  where  it  discharges  into  a  plank-drain, 
eight  by  twelve  inches,  which  again  discharges  into  the  river.  The 
fall  is  from  ten  to  twelve  feet.  There  are  no  traps  nor  pipes  to  carry  off 
sewer  gas.  The  conductors  from  the  roof  discharge  into  the  sewer. 
The  mouth  of  the  sewer  a  great  part  of  the  year  is  below  water  in  the 
river.  A  branch  of  this  sewer,  made  of  six-inch  socket-tile,  cemented, 
extends  into  the  asylum  kitchen. 

There  are  no  water-closets  within  doors. 

Farm  and  garden. — The  farm  consists  of  one  hundred  and  eighty 
acres,  eighty  or  ninety  of  which  are  arable.  It  has  a  young  orchard 
just  coming  into  bearing.  One  and  a  quarter  acre  is  devoted  to  a 
garden,  in  which  are  raised  vegetables  in  great  variety,  including  pota- 
toes, beans,  peas,  beets,  turnips  and  carrots.  Some  sweet  corn  and 
vegetables  are  also  raised  upon  the  farm.     Thirteen  milch  cows  are 


42  Report  on  the  Chronic  Insane. 

kept.  The  butter  used  is  made  on  the  place.  The  farm  in  all  its 
appointments  is  highly  creditable.  Buildings  and  fences  appeared  in 
good  order  and  every  thing  in  its  place.  The  garden  was  well  planted 
and  free  from  weeds.  The  quantity  and  quality  of  out-door  products 
indicated  a  "  land  of  plenty."  The  grounds  in  front  of  the  house 
were  well  kept,  showing  care  and  taste,  and  the  whole  outward  appear- 
ance of  the  institution  and  its  surroundings  was  inviting. 

The  visitation  was  made  by  Commissioner  Letch  worth,  October  4, 
1881. 

Erie  County. 

The  alms-house  of  this  county  is  located  on  Main  street,  about  five 
miles  north-easterly  from  the  business  center  of  the  city  of  Buffalo,  on 
the  old  State  turnpike  road,  and  about  one  mile  north  from  the  Main 
street  station  on  the  New  York,  Lake  Erie  and  Western  railroad. 
Buffalo  Plains  is  the  post-office. 

Officials  and  emjjloyes. —  The  keeper  of  the  alms-house  has  also 
supervisory  charge  of  the  insane  department,  and  is  appointed  by  the 
board  of  supervisors  at  a  salary  of  $1,300  a  year,  with  living  tor  him- 
self and  family. 

The  superintendent  of  the  insane  department  is  appointed  by  the 
keeper  of  the  alms-house.  His  compensation  is  $1,200  per  year,  with 
living.  His  wife  is  matron  and  receives  a  salary  of  §416  a  year.  An 
assistant  is  also  appointed,  whose  compensation  is  fixed  at  $900  a  year, 
with  living. 

There  are  six  male  attendants^mployed  at  a  salary  of  S30  per  month 
each,  one  hospital  steward,  six  female  attendants  at  $-4  per  week,  one 
cook  for  the  keeper's  family  at  $5  per  week,  one  dining-room  girl  at 
$4  per  week,  one  female  cook  for  the  insane  at  ^b  per  week,  one  female 
nurse  for  women's  hospital  at  $2  per  week.  Employes  are  ai)pointed 
by  the  keeper  of  the  alms-house.  There  are  no  paupers  in  the  care  of 
the  insane. 

The  keeper  of  the  alms-house  prescribes  the  duties  and  regulates  the 
conduct  of  the  attendants.  Printed  rules  similar  to  those  in  use  at 
the  State  asylum  are  placed  in  the  hands  of  each  attendant. 

Medical  supervision. —  The  resident  physician,  Charles  A.  Ring,  M. 
D.,  is  alsoai)pointed  by  the  keeper  of  the  alms-house,  at  a  salary  of  §600 
a  year,  with  board.  He  and  the  attendant  under  his  direction  dis- 
pense the  medicine. 

The  dispensary  connected  with  the  office  of  the  physician  is  an  at- 
tractive feature  of  the  institution. 

A  "case  book,"  but  no  "  prescription  book,"  is  kept. 

The  insane  are  registered  at  the  main  office  and  also  at  the  oSice  of 
the  insane  department. 

General  description. —  The  main  or  administration  building  of  the 
insane  department  was  erected  in  1874,  from  a  plan  approved  by  the 
State  Board  of  Charities.  This,  although  carried  out  generally,  was  in 
some  respects  dejjarted  from. 

The  front  part  contains  the  office,  reception-room,  rooms  for  the 
asylum  superintendent  and  his  family,  and  apartments  for  officers 
and  employ6s.  The  rear  contains  on  the  first  tloor,  dining-rooms  for 
patients,  also  asylum  kitchen,  pantries  and  store-rooms;  on  the  second 


Report  on  the  Chronic  Insane.  43 

floor,  two  associate  dormitories,  one  having  fourteen  beds,  the  other 
eighteen;  also,  a  large  room  used  for  sewing.  On  the  third  floor  are 
two  hospital-rooms,  one  for  either  sex,  and  an  associate  dormitory  for 
men,  with  eleven  beds. 

The  windows  of  this  building  are  six  feet  nine  inches  by  two  feet 
six  inches,  have  two  sashes  suspended  by  weights,  and  are  protected  by 
vertical  iron  rods,  painted  white  and  placed  opposite  the  sash  bars. 

In  the  rear  is  the  boiler-house,  between  which  and  the  main  part  it 
is  proposed  to  place  the  laundry.  An  old  stone  building,  temporarily 
fitted  up,  is  now  used  for  that  purpose. 

ThVough  the  center  of  the  build'ing  extends  transversely  a  hall  con- 
necting with  the  wings  on  either  side  and  having  separate  flights  of 
stairs  at  each  end. 

The  left  or  south  wing  for  women,  one  hundred  and  fifty-six  by 
fifty-seven  feet,  is  three  stories  high,  and  was  erected  in  1877.  Each 
floor  has  a  central  hall  with  dormitories  on  either  side,  also  bay  win- 
dowo. 

There  are  eight  single  rooms  for  patients,  and  four  associate  dormi- 
tories, each  of  the  latter  containing  eight  beds.  Each  floor  has  a  sepa- 
rate dining-room,  also  two  attendants'  rooms,  lavatory,  bath-room, 
supplied  with  hot  and  cold  water,  and  water-closets.  A  dumb-waiter 
communicates  with  each  floor,  also  a  dust-flue.  From  the  kitchen, 
food  is  conveyed  along  a  tramway  extending  through  the  cellar  to  the 
north  and  south  wings,  thence  by  means  of  the  waiters  it  is  lifted 
to  the  several  wards. 

On  the  first  floor  are  the  more  quiet  and  epileptic  cases ;  on  the 
second,  the  better  class  of  inmates  who  sew  and  do  other  work, 
and  have  more  freedom  ;  on  the  third,  the  filthy  and  more  vio- 
lent. 

The  right  or  north  wing  for  men  was  erected  in  1879.  It  is  of  the 
same  size  and  general  plan  as  the  south  wing.  The  windows  have 
iron  sashes  but  no  gratings,  within  or  without. 

On  the  first  floor  are  the  men  who  work  the  farm ;  on  the  second, 
the  more  quiet;  on  the  third,  the  epileptic  and  filthy  cases.  The  su- 
perintendent determines  the  classification. 

In  the  hospital-room  for  women  were  five  patients,  and  six  in  that 
for  men.  The  rooms  were  clean  and  cheerful  and  an  attendant  was 
present  in  each.  In  consequence  of  the  insufiiciency  of  these  apart- 
ments some  of  the  patients  are  treated  in  the  single  rooms  of  the  gen- 
eral wards. 

The  following  diagram  (A)  shows  the  ground  plan  of  the  insane 
department,  while  diagram  (B)  illustrates  one  of  the  wards  and  the 
uses  of  its  various  parts. 

The  insane  department  is  designed  to  accommodate  about  three  hun- 
dred patients.  The  total  expenditure  for  buildings,  steam  boiler, 
heating  apparatus  and  prospective  laundry  building  is  estimated  in 
round  figures  at  8100,000.  The  buildings  are  of  stone,  quarried  on 
the  premises,  with  the  aid  of  the  insane. 

Each  ward  is  furnished  with  several  comfortable  settees  of 
varnished  wood,  rocking  and  other  chairs,  a  clock  and  a  table. 
The  bay  windows  are  provided  with  colored  shades  and  were 
at  the  time  of  visit  brightened  by  plants.  Framed  chromos  and  other 
pictures  hung  upon  the  walls. 


44  Report  on  the  Chronic  Insane. 

The  furnishing  of  the  single  rooms  consisted  of  a  chair,  a  wooden 
bedstead,  witli  strap  iron  bottom,  Willard  asylum  pattern,  a  tick  filled 
with  straw,  two  sheets,  a  counterpane,  straw  pillow  and  commou  husk 
bolster. 

The  associate  dormitories  were  similarly  furnished,  one  chair  being 
allowed  to  each  bed.  A  few  of  the  single  rooms  contained  articles  of 
luxury  and  taste,  brought  by  friends  of  the  patients,  and  one  dormi- 
tory was  decorated  with  a  number  of  paper  birds,  crosses  and  flowers 
made  by  an  inmate. 

An  effort  was  apparently  made  to  keep  the  wards  clean,  but  there 
was  not  the  perfect  order  observable  that  would  indicate  efficient  ad- 
ministration. A  number  of  attendants  were  absent  from  their 
posts  of  duty,  and  the  separateness  and  independence  of  the  functions 
of  the  physician  from  those  of  the  superintendent,  did  not  seem  to  be 
clearly  defined.  While  there  was  no  actual  conflict,  there  appeared  to 
be,  on  the  part  of  the  latter,an  assumption  of  power  and  responsibility 
properly  belonging  to  the  physician. 

The  dining-rooms  were  provided  with  deal  tables,  Windsor  chairs, 
having  bent  rail ;  the  table  furniture  consisting  of  crockery  ware,  ordi- 
nary knives  and  forks,  except  in  the  case  of  disturbed  patients,  where 
tinware  is  substituted  and  knives  and  forks  are  not  used. 

In  the  laundry  are  fourteen  stationary  and  eight  ordinary  tubs, 
together  with  the  usual  laundry  appliances,  also  separate  rooms  for 
ironing  and  drying  clothes. 

The  yard  for  women,  one  hundred  and  eighty-five  by  one  hundred 
and  fifty  feet,  recently  planted  with  trees,  has  several  settees  and 
benches,  also  a  central  pavilion,  twenty-four  feet  square,  provided 
with  seats. 

Heating  and  ventilation. —  The  main  building  is  warmed  by  stoves  ; 
the  wings  by  steam.  Radiators  are  placed  in  the  halls  and  in  each 
dormitory.  Heat  is  admitted  to  the  single  rooms  through  a  perforated 
plate  at  the  bottom  of  the  doors  and  through  the  transoms. 

Ventilation  is  effected  by  means  of  a  lai-ge  air  shaft,  in  which  is 
the  iron  smoke-stack  from  the  boilers.  The  system  at  present  ex- 
tends only  to  the  north  wing,  but  it  is  intended  to  include  also  the 
south  wing,  the  connections  being  already  prepared  within  the  build- 

The  present  ventilation  in  this  latter  wing  is  somewhat  defective. 

Dietary. —  The  following  is  given  as  the  dietary:  "For  breakfast, 
coffee,  bread  and  molasses,  with  hash  three  times  a  week." 

For  dinner  the  range  of  articles  from  which  to  select  includes 
"  vegetable  soup,  rice  soup,  corned  beef,  and  stewed  fresh  beef,  potatoes, 
beans,  cabbage,  beets,  carrots  and  other  vegetables ;  codfish  on  Fri- 
days." 

For  supper,  ''corn  meal  mush,  bread,  molasses,  tea  or  coffee;  some- 
times cold  meat  and  fried  potatoes." 

The  laboring  men  have  beefsteak  or  sausage  for  breakfast,  and  the 
women  who  work  in  laundry,  tea  for  dinner.  Sugar  and  milk  are 
used  in  both  tea  and  coffee.  All  the  inmates  have  more  or  less  fruit 
when  in  season. 

The  diet  of  the  hospital  comprises  eggs  and  milk,  and  sometimes 
dishes  are  brought  from  the  superintendent's  table. 

The  physician  prescribes  the  diet. 


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Eeport  on  the  Chronic  Insane.  45 

Clothing. —  For  men  in  summer  blue  denim  overshirt  and  pants; 
white  shirts,  cotton  socks,  straw  hat,  shoes  or  boots.  Those  who  are 
in-doors  wear  slippers.  In  winter  woolen  under-clothing  is  worn,  and 
those  who  work  out  of  doors  have  woolen  pants,  woolen  knitted  jackets 
with  caps  and  mittens.  For  women,  in  summer,  cotton  underwear, 
with  skirt,  blue  dress,  stockings  and  straw  hats.  In  winter,  an  addi- 
tional skirt  and  woolen  hoods  are  provided. 

Employment.  —  Some  of  the  men  are  employed  at  farm  labor, 
plowing,  hoeing,  jilanting,  mowing,  reaping,  cutting  wood,  etc., 
others  work  in  the  garden. 

A  few  mechanics  work  at  their  trades.  Several  work  about  the 
house,  making  beds,  scrubbing  floors,  washing  windows,  and  assist- 
ing in  the  dining-rooms. 

The  women  knit,  sew,  wash,  iron,  and  do  general  housework. 

The  superintendent  says,  '''  Twenty  of  the  men  perform  a  fair  day's 
labor;  the  others  don't  do  much.  They  accomplish  about  half  as 
much  as  sane  laborers." 

The  farm  contains  one  hundred  and  fifty-four  acres  of  land  of 
average  quality  and  moderately  productive. 

Restraint. —  In  one  of  the  dormitories  on  the  women's  side  was 
an  open  crib,  having  wooden  slats,  with  straw  tick,  and  ordinary 
bedding  ;  four  restraining  chairs,  two  with  and  two  without  padlocks, 
one  muff,  with  belt  and  wristlets,  were  in  another  apartment. 

In  one  of  the  single  rooms  on  the  lower  floor  was  a  restraining  chair 
with  arms  and  back  of  square  studding  and  a  thick  plank  seat.  Here 
was  secured  a  woman,  by  an  adjustable  plank  in  front  rounded  to  fit 
the  person,  and  further  restrained  by  a  muff  with  Avristlets.  In  the 
same  room  was  another  restraining  chair  not  in  use  at  the  time  of 
visit. 

Another  room  contained  a  crib  three  feet  eleven  inches  long,  two 
feet  eight  inches  wide,  and  two  feet  four  in  height,  with  a  cover  of 
slats  secured  by  hasp  and  padlock.  In  this  room  was  also  a  restrain- 
ing chair. 

In  the  upper  ward  of  the  male  department  were  two  patients, 
strapped  without  muff,  and  four  with  muff  and  wristlets.  There 
were  also  three  restraining  chairs,  two  with  open  seats,  and  one  crib 
without  cover. 

One  of  the  dormitories  contained  four  cribs  with  covers,  said  to  be 
used  only  at  night  for  beds.  In  this  ward  were  also  three  restraining 
chairs  with  straps,  and  one  pair  of  handcuffs,  two  cribs  with  and  two 
without  covers ;  several  of  the  restraining  chairs  have  open  seats  and 
stocks  for  feet. 

The  superintendent  said  ''  camisoles  are  not  used."  In  the  ward 
below  was  one  crib  with  cover,  one  restraining  chair,  one  pair  mana- 
cles, one  muff  with  strap.  There  are  no  secure  rooms  for  the  con- 
finement and  isolation  of  the  insane. 

The  institution  contained  in  all  sixteen  cribs,  of  which  eight  are 
open  and  eight  closed  ;  twelve  restraining  chairs,  four  having  open 
seats  and  stocks  for  the  feet,  and  three  restraining  straps.  There  are 
nine  muffs  with  belts  and  twelve  waist  straps ;  of  camisoles  there  are 
fifteen,  and  two  pairs  of  handcuffs.  The  superintendent  said,  "  these 
comprise  all  the  modes  of  restraint  in  use." 

The  rule  is  that  the  attendant  report  to  the  physician,  and  the  physi- 


46  Report  on  the  Chbonic  Insane. 

cian  shall  regnlate  the  restraint.  This  it  was  said  was  not  observed; 
frequently  the  restraints  are  not  reported  till  the  following  day.  There 
are  no  dark  rooms  nor  cells,  and  punishment,  it  was  said,  is  not  in- 
flicted. 

Water  supply. —  The  e.xamination  of  the  water  supply  confirmed 
previous  conclusions,  that  it  was  greatly  deficient,  and  the  health  of 
the  inmates  was  suffering  in  consequence.  This  was  so  manifest 
that  a  communication  on  the  subject  was  addressed  to  the  board  of 
supervisors  of  Erie  county,  and  presented  at  the  opening  6f  its  ses- 
sion October  11,  18S1,  of' which  the  following  is  a  copy. 

Buffalo,  Oct.  10, 1881. 

To  the  Hoyiorable  the  Board  of  Supervisors  of  Erie  county,  N.  Y.: 

Gentlemen  —  In  making  an  examination  of  the  water  snpply  at 
the  Erie  county  alms-house  on  the  8th  and  9th  days  of  September 
last,  it  was  found  that  the  wells,  of  which  there  are  several,  were 
virtually  dry,  and  that  the  rain  water  in  the  capacious  cisterns  of  the 
establishment  had  been  exhausted.  In  this  extremity  recourse  was 
had  to  a  distant  well,  from  which  water  was  being  hauled  by  teams 
for  drinking  and  for  cooking  purposes.  To  meet  other  deniands, 
leather  hose^'was  laid  to  a  pond  about  fourteen  hundred  feet  distant 
from  the  alms-house,  through  which  water  was  forced  by  means  of  a 
hand  lever  pump  to  cisterns,  in  which  it  underwent  a  process  of  filtra- 
tion before  being  used.  But  little  water  was  found  in  the  pond.  This 
was  tinged  green  and  yellow  and  gave  evidence  of  great  impurity.  An 
examination  of  this  water  after  being  filtered  showed  it  to  be  of  a  pale 
amber  hue  and  containing  floating  particles.  The  water  of  this  stag- 
nant pond,  divested  of  its  surrounding  contaminations,  is  deemed  un- 
suitable for  domestic  use.  There  is  a  well  upon  the  grounds,  said  to 
have  been  bored  two  hundred  and  eighty-two  feet,  from  wiiich  it  was 
contemplated  to  pump  water  by  means  of  a  wind-mill.  This  has 
practically  proved  a  failure.  The  water  from  this  source  is  not 
adapted  to  the  uses  of  the  house,  unless  subjected  to  a  chemical  pro- 
cess which  would  be  expensive. 

In  the  insane  asylum  the  water-closets  at  times  cannot  be  used  as 
originally  intended,  for  lack  of  water,  and  in  consequence  a  highly 
objectional  condition  of  the  atmosphere  is  frequently  the  result. 

At  times  it  has  been  necessary  for  a  succession  of  weeks  to  melt 
snow,  to  meet  the  general  needs  of  the  house. 

On  the  days  of  visitation  there  were  nearly  seven  hundred  inmates, 
and  at  times  this  number  is  largely  increased.  The  minimum  amount 
of  water  requisite  for  all  the  purposes  of  such  an  institution,  accord- 
ing to  the  best  authorities,  is  forty  gallons  per  inmate;  the  maximum, 
sixty  gallons.  At  the  minimum  rate  this  would  require  twenty-eight 
thousand  gallons  daily. 

In  providing  a  supply  it  would  be  wise  perhaps  to  estimate,  not 
only  for  an  increased  number  of  inmates,  but  also  for  any  future  en- 
largement of  the  institution.  The  supply  of  water  at  the  alms-house 
has  always  been  greatly  deficient,  either  to  meet  its  sanitary  require- 
ments, or  for  protection  against  fire,  from  which  it  has  largely  suffered 
by  the  destruction  of  its  buildings. 

Under  existing  conditions,  I  feel  justified  in  earnestly  entreating 


Report  on  the  Chronic  Insane.  47 

you  to  give  early  consideration  to  this  important  subject,  that  such 
action  may  be  taken  by  your  honorable  body  as  shall  provide  for  the 
alms-house  an  abundantsupply  of  pure  and  wholesome  water. 

Very  respectfully, 

WM.  P.  LETCH  WORTH, 
Commissioner  of  the  State  Board  of  Charities,  Eighth  Judicial  District. 

Setoerage. —  Several  eight-inch  cemented  socket-tile  sewers  extend 
from  the  asylum  building  to  a  twelve-inch  tile  sewer,  which  discharges 
into  a  walled  drain  about  two  feet  square  near  the  poor-house  build- 
ing. This  extends  one  hundred  and  sixty-seven  yards  and  then  dis- 
charges into  an  open  ditch  fifty-five  yards  from  the  highway.  The 
system  of  sewerage  is  defective. 

General  observations. —  Regarding  out-door  amusements  for  men  the 
superintendent  says  :  "  We  "have  ball  playing.  The  balls  are  made  of 
soft  rags  covered  with  leather.     In-doors  the  men  play  checkers." 

There  are  no  out-door  nor  in-door  amusements  in  common  for  both 
sexes. 

Papers  are  occasionally  supplied  by  benevolent  societies  and  indi- 
viduals. 

There  is  a  contribution  box  in  the  institution  for  visitors;  the  pro- 
ceeds are  devoted  to  the  purchase  of  books  and  papers  for  the  inmates. 

It  is  matter  for  regret  that  expenditures  have  been  made  in  connec- 
tion with  this  asylum  not  in  accordance  with  the  original  plan,  ap- 
proved by  the  State  Board  of  Charities,  nor  in  keeping  with  true 
economy.  A  small  old  stone  building,  cheaply  constructed  and  badly 
planned,  which  stood  in  the  rear  of  the  men's  wing,  was  to  have  been 
taken  down  and  its  material  used  in  constructing  (as  already  shown 
in  diagram  A)  a  wash-house  in  rear  of  the  administrative  depart- 
ment and  between  the  kitchen  and  the  boiler-house.  A  considerable 
sum  has  been  expended  in  reshaping  and  refitting  this  building  for 
temporary  occupancy  as  a  laundry,  and  in  constructing  a  subterranean 
passage  to  it  from  the  kitchen,  with  stairs  at  either  end.  The  conse- 
quence is  that  the  plan  of  the  asylum  is  incomplete,  and  one  of  its  pri- 
mary aims  defeated.  The  building,  being  occupied  by  women  and  be- 
ing on  the  men's  side,  is  in  violation  of  one  the  first  principles  of  proper 
classification,  viz. :  the  separation  of  the  sexes.  The  building  and  its 
surrounding  yard  are  now  overlooked  from  the  men's  wards,  and  the 
men  by  this  arrangement  are  deprived  of  a  yard  in  proper  location. 
It  has  become  necessary  to  make  a  long  narrow  inclosure  for  them 
some  distance  beyond,  which  again  encroaches  upon  the  women's  de- 
partment in  the  poor-house.  i3ut  for  this,  with  a  sufBcient  supply  of 
water  and  some  change  in  sewerage,  the  provision  liere  made  for  the 
chronic  insane  would  reflect  credit  upon  the  county.  And,  indeed,  the 
liberal  spirit  manifested  by  the  people  in  this  direction  is  worthy  of 
note. 

As  the  rules  of  the  State  Board  of  Charities  require  that  a  resident 
physician  should  be  employed  in  places  where  there  are  over  one  hun- 
dred insane,  the  attention  of  the  keeper  of  the  alms-house  was  directed 
to  this  point  and  a  request  made,  through  the  Secretary  of  the  Board, 
that  a  resident  medical  superintendent  be  placed  in  charge  of  the 
asylum  department.  The  request  has  been  complied  with,  so  far  as 
regards  the  employment  of  a  physician,  but  he  is  made  subordinate 
7 


48  Report  on  the  Chronic  Insane. 

to  a  superinteiideut  and  assistant  superintendent,  and  his  sphere  of 
usefulness  thereby  circumscribed.  There  is  no  doubt  but  that  a  resi- 
dent medical  superintendent,  with  a  competent  matron  and  a  well-se- 
lected corps  of  attendants,  could  properly  administer  the  atfuirs  of  the 
insane  department,  disi)ensing  with  a  general  superintendent  and  an 
assistant  superintendent,  and  thus  effect  a  saving  of  several  thousand 
dollars  yearly  in  salaries.  It  is  believed  that  not  only  greater  economy 
but  better  administration  would  in  this  way  be  attained. 

The  inspection  was  made  by  Commissioner  Letch  worth,  September  9, 
1881. 

Genesee  County. 

This  county  claims  the  right  under  a  special  statute  to  receive  and 
treat  not  only  chronic,  but  acute  cases  of  insanity. 

The  poor-house  is  located  in  the  town  of  Bethany,  distant  one  and 
a  half  mile  from  Linden  station,  on  the  New  York,  Lake  Erie  and 
Western  railroad,  and  nine  miles  from  Batavia. 

The  site  of  the  building  is  elevated  and  commands  an  extensive 
prospect.  The  ground  in  front  of  the  main  building  has  recently  been 
planted  with  flowers,  and  the  fence  removed.  The  farm  contains  one 
hundred  and  eighty  acres  of  land,  besides  a  timbered  lot  of  fifty  acres 
one  and  a  half  mile  distant.  A  fruit-bearing  orchard  of  eight  acres, 
furnishes  plenty  of  apples  for  the  inmates. 

Officers  and  emploi/es. — The  poor-house  institution  is  under  the  con- 
trol of  three  superintendents  of  the  poor,  who  are  elected  by  the  peo- 
ple, and  hold  office  for  three  years.  The  keeper  resides  in  the  building 
and  receives  an  annual  compensation  of  §700,  and  living  for  himself 
and  wife,  she  acting  as  matron.  A  female  assistant  receives  12.50  per 
week.   A  man  is  employed  for  work  upon  the  farm. 

In  the  insane  department  are  two  paid  attendants  ;  a  man  at  120 
per  month  and  board,  and  a  woman  at  ^3  per  week  and  board. 

The  keeper  prescribes  the  duties  and  regulates  the  conduct  of  the 
attendants  under  direction  of  the  physician. 

Afedical  supervision. — The  visiting  physician  resides  one  and  a  half 
mile  distant,  at  the  village  of  Bethany.  He  visits  the  poor-house  every 
other  day,  and  oftencr  if  required.  His  compensation  is  $175  per 
year,  which  includes  medicines,  with  the  exception  of  such  supplies  as 
are  kept  in  the  house.  No  extra  allowance  is  made  for  surgical  opera- 
tions. The  medicines  are  dispensed  by  the  attendants  under  direction 
of  the  physician.  At  present,  the  sick  are  treated  in  their  rooms. 
There  is  no  consulting  physician.  The  doctor  said  :  "  No  acute  cases 
have  been  received  here  within  a  year ;  they  may  be  received,  however, 
if  brought." 

General  description. — The  main  poor-house  structure,  built  over  fifty 
years  ago,  is  of  brick,  two  stories  high  and  thirty  by  forty  feet.  It  is 
occupied  as  the  keeper's  residence,  office,  etc. 

Situated  in  the  rear  of  the  main  structure  is  a  largo  two-storied 
wooden  building.  The  lower  story  is  used  for  kitchen  and  dining 
purposes,  and  the  upper  story  for  sleeping  apartments. 

Some  delay  occurred  in  beginning  the  tour  of  inspection,  in  conse- 
quence of  the  absence  of  the  male  attendant  in  charge  of  the  insane 
men.     He  was  temporarily  absent  on  the  farm  and  had  with  him  the 


Report  on  the  Chronic  Insane.  49 

keys  of  the  men's  ward,  which  was  locked.     The  general  exterior  of 
the  building  for  the  insane  resembles  that  of  a  county  jail. 

The  department  for  the  insane  is  situated  north  of  the  main  build- 
ing. It  is  twenty-six  by  thirty  feet,  built  of  cobble-stone  with  cut 
stone  corners.  The  walls  are  somewhat  dilapidated,  the  corners  of  the 
building  especially  showing  signs  of  weakness.  The  Avindows  are  pro- 
tected on  the  outside  by  strong  liorizontal  iron  bars,  bolted  to  the 
frame. 

Connecting  the  main  building  to  the  insane  asylum  is  a  i)uild- 
ing  forty  by  fourteen  feet — the  lower  story  of  cobble-stone  and  the 
second  story  of  wood. 

The  rooms  are  ranged  on  one  side  of  a  hall.  They  are  ceiled  and 
painted  throughout  and  have  ceilings  eight  feet  four  inches  high. 
They  were  unoccupied  on  the  day  of  visitation. 

The  doors  are  constructed  of  double  boards  laid  transversely,  each 
having  an  opening  five  by  eleven  inches.  They  are  covered  by  an  iron 
grating  and  secured  by  heavy  iron  bolts  and  padlock. 

The  windows  are  suspended  at  the  top  by  hinges  and  secured  by 
lock.  They  are  protected  by  a  frame-work  of  slats  one  by  two  and  a 
half  inches,  having  half-inch  openings  for  admission  of  light  and  air. 

The  hall  on  the  first  floor  of  the  main  building  is  ceiled  and  painted. 
Light  is  admitted  by  two  windows  having  inside  iron  gratings  of  hori- 
zontal rods,  two  inclies  apart.  Two  benches  with  backs,  a  heavy  deal 
table,  and  a  pair  of  manacles  comprised  its  only  furniture.  A  rusty 
stove-pipe  passes  from  the  furnace  in  the  cellar,  through  the  floor  to 
the  ceiling  above.  The  joint  next  the  floor  was  much  battered.  A 
register  in  the  floor  admits  heat  direct  from  the  furnace. 

In  the  hall  were  two  patients,  one  of  whom  it  was  alleged  had  been 
in  the  institution  for  years.  His  dress  was  of  heavy  gray  cottonade. 
He  wore  no  shirt,  and  was  bare-footed.  His  hair  was  cut  close.  He 
was  said  to  be  filthy  at  times.  The  other  was  dressed  in  ordinary  citi- 
zen's clothing  with  felt  hat. 

Opening  out  of  this  hall  are  four  bed-rooms.  One  of  these  is  much 
defaced,  and  in  a  corner  was  observed  a  funnel-shaped  box  twelve 
inches  square  used  as  a  night-vessel,  the  excrement  falling  into  a  pail 
placed  on  a  shelf  in  the  cellar  below.  The  sides  of  the  box  were  in  a 
filthy  condition,  and  the  ventilation  being  inadequate  the  air  was  ex- 
tremely offensive.  The  same  arrangement  and  uncleanliness  were  ob- 
served in  adjoining  rooms.  All  the  doors  on  this  floor  have  bolts 
additionally  secured  by  chain  and  padlock. 

Communicating  with  the  yard  in  the  south-east  corner  of  the  build- 
ing is  a  small  hall  provided  with  bath-tub  and  roller-towel.  Cold 
water  is  supplied  from  a  rain-water  tank  in  the  attic,  hot  water  being 
brought  in  pails.     The  hall  is  painted  and  evidenced  cleanliness. 

The  women's  department  is  upon  the  second  floor  and  is  reached 
from  the  hall  by  a  narrow  flight  of  steps.  In  the  connecting  building 
the  hall  and  rooms  are  ceiled  and  painted  throughout.  The  doors  are 
of  double-inch  bo;irds  matched.  Some  have  open  gratings  and  all  are 
provided  with  iron  bolts  and  locka.  The  windows  are  without  grat- 
ings and  are  formed  of  two  wooden  sashes  fastened  with  bolts. 
They  measure  two  feet  eight  inches  by  four  feet.  The  furniture  of  the 
rooms  consisted  of  wooden  bedsteads  and  bedding.  The  floors  were 
bare  and  muslin  shades  screened  the  windows.  The  hall  windows  also 
had  muslin  shades. 


50  Report  on  the  Chronic  Insane. 

One  of  these  rooms  was  occupied  by  a  male  paying  patient.  His 
apartment  contained  patent  iron  bedstead,  with  wire  bottom,  straw 
tick,  two  sheets,  one  quilt,  colored  counterpane,  straw  bolster,  feather 
pillow,  carpet  rug,  small  cushioned  rocker,  painted  deal  table,  upon 
which  was  noticed  a  comb  and  brush.  A  scriptural  motto  was  upon  the 
wall,  and  clean-looking  clothing  and  comfortable  morning-gown  hung 
upon  the  side  of  the  room. 

The  ante-room  leading  to  the  main  hall  serves  as  a  bed-room  for  a 
pauper,  and  a  dining-room  for  three  female  i)atients.  The  furniture 
consisted  of  a  patent  bedstead,  chair,  rocking-chair,  table  with  oil- 
cloth cover,  wash-stand,  pail  and  basin.  The  door  entering  the  main 
hall  is  grated. 

In  this  hall  was  a  paying  patient,  dressed  in  calico  and  wearing  a 
sun-bonnet  of  the  same  material  ;  also  a  pauper  patient  said  to  be  de- 
structive of  her  clothing,  and  an  idiot  attired  in  a  long  gingham  gown, 
without  belt  or  collar.  The  hair  of  the  latter  was  cut  close  and  her 
feet  were  bare. 

The  main  ward  measures  thirteen  by  fifteen  feet,  and  its  ceilings  are 
seven  feet  high.  It  contains  five  rooms;  its  windows,  four  feet  six 
inches  by  two  feet  three  inches,  are  grated  with  horizontal  iron  rods 
set  in  frames  secured  by  padlock.  The  doors  in  construction  and  in 
respect  to  gratings,  bolts  and  outer  locks  are  similar  to  those  just 
described.  The  entire  ward  and  its  rooms  are  ceiled  with  wood, 
painted,  and  at  the  time  of  inspection  were  commendably  clean  and 
in  order. 

In  the  hall  was  a  Avoodeu  settee  and  chair,  a  deal  table  with  oil- 
cloth cover,  a  cup-bourd  for  dishes,  secured  by  hasp  and  padlock. 
The  floor  was  painted  and  the  walls  bare.  The  smoke-pipe  from  the 
furnace  below  passes  vertically  through  to  the  attic  above,  protected, 
however,  by  a  grated  box. 

The  rooms  contained  bedding  as  before  described.  One  bedstead 
was  of  iron,  the  others  wooden,  of  the  Willard  asylum  pattern.  One 
room  occupied  by  a  pauper  patient  had  the  additional  furnishing  of  a 
featherbed,  flag-bottomed  chair  and  painted  foot-stool.  The  south- 
east room  upon  this  floor,  with  the  usual  bed-room  furniture,  has  also 
an  iron  bath-tub,  supplied  with  cold  water  from  a  tank  in  the  attic. 

Nine  women  occupy  the  rooms  on  this  floor,  two  of  whom  are  quiet 
patients,  who  were  working  in  the  poor-house  building  at  the  time  of 
our  visit. 

In  the  unfinished  attic,  under  the  bare  rafters,  were  hung  the  winter 
dresses  of  the  patients,  the  under-clothing  being  arranged  over  a  line. 
Through  tlie  roof  and  its  sides  were  crevices  affording  here  and  there 
a  glimpse  of  the  sky.  The  dila^ndation  of  this  building  at  the  time  of 
inspection  amounted  almost  to  insecurity. 

The  yard  for  men,  seventy  by  thirty  feet,  is  in  view  of  the  women's 
department.  It  is  inclosed  by  a  tight  planed  board  fence,  eleven  feet 
high,  and  is  provided  with  out-door  conveniences  on  the  plan  of  an 
earth-box,  which  can  readily  be  drawn  out  and  cleaned.  This  it  was 
said  is  done  once  in  three  mouths.  The  grass  is  short  and  partially 
worn  into  paths. 

The  yard  for  women  is  on  the  east  side  of  the  building,  fifty  by 
sixty-six  feet,  and  surrounded  by  a  tight  board  fence  eleven  feet  high, 
planed  and  painted.     Out-door  conveniences  are  provided  similar  to 


Report  on  the  Chronic  Insane.  51 

those  already  described.  In  the  center  of  the  yard  a  large  post  was 
noticed,  to  which  it  was  said  a  violent  patient,  since  transferred _  to 
the  Willard  asylum,  was  formerly  chained,  "  to  prevent  his  hurting 
other  patients."  The  yard  was  sparsely  sodded  and  in  many  places  the 
frrass  was  worn  entirely  away  by  the  continued  tread  of  patierts. 

Here  were  women,  two  of  whom  were  paying  patients.  These  latter 
were  better  dressed  and  wore  sun-bonnets.  The  retrospective  fatuity  in  a 
patient  was  here  somewhat  touchingly  revealed.  One  woman,  whose 
hair  was  cut  close,  with  much  earnestness  related  her  troubles  and 
among  other  things  bewailed  the  loss  of  hair.  '•  I  suppose,"  she  said, 
"  you  have  come  to  see  the  crazy  people.  Well,  we  are  not  much  more 
crazy  than  the  people  who  keep  us  here.  Wiien  I  was  a  child  I  visited 
the  Rochester  Insane  Asylum  with  my  parents  and  my  little  brother. 
I  recollect  we  gave  the  crazy  people  some  pennies  and  it  pleased  them  ; 
now  I  am  confined  here  with  the  insane  and  my  hair  is  cut  off.  I 
want  to  get  out  and  go  home." 

Another  whose  lower  limb  was  exposed,  badly  swollen,  livid  in  color, 
and  presenting  a  raw  and  fearful  sore,  was  said  to  occupy  a  room  in  the 
poor-house  department. 

In  the  rear  and  beyond  the  yards  is  a  wooden  building,  one  and  a 
half  story,  and  eighteen  by  forty-two  feet,  called  the  "  old  school- 
house."  Here  were  four  insane  and  two  idiot  women  under  the  charge 
of  a  female  also  of  unsound  mind,  who  had  formerly  been  a  pauper. 

In  the  front  part  of  the  building  is  the  attendants'  room,  plainly 
furnished,  warmed  by  a  box-stove,  the  pipe  from  which  passes  through 
the  adjoining  ceiling.  In  the  rear  is  an  apartment  for  inmates  eleven 
by  twenty- four  feet ;  the  door  leading  to  it  is  grated  with  vertical 
iron  rods.  This  room  is  furnished  with  three  wooden  benches,  and  a 
low-deal  dining-table,  the  food  being  brought  from  the  poor-house 
department.  The  ceiling  is  seven  feet  four  inches  high.  Small 
rooms  open  from  this  on  the  left,  and  all  are  ceiled  throughout.  On 
the  floor  in  one  corner  of  the  mainroom  sat  an  old  woman  said  to 
have  been  in  the  institution  thirty  years.  She  wore  an  old  hood  and 
a  butternut-colored  gown.  Her  feet  were  wrapped  in  cloths  tied  by 
strings,  with  which  her  hands  were  constantly  occupied.  She  was  in 
a  violent  and  excited  state,  her  speech  loud  and  profane.  An  idiotic 
female,  twenty-two  years  old,  whom  it  was  necessary  to  feed,  was 
crouched  on  a  bench,  her  feet  under  her,  with  one  hand  partially 
stuffed  in  her  mouth.  She  appeared  to  suffer  painfully  from  the  flies 
which  had  collected  in  the  creases  about  her  mouth  and  eyes.  She 
had  not  the  sense  to  drive  them  away.  She  was  dressed  in_  a  loose 
gown  and  was  bare-footed,  as  were  all  the  inmates  of  this  building._ 

Off  this  hall  is  a  room  thirteen  feet  six  inches  by  seven  feet,  occupied 
by  an  idiot,  who  sleeps  in  a  wooden  bunk.  The  bedding  here  was  in 
order,  but  the  air  was  impure.  Here  also  was  a  wooden  bedstead  with 
counterpane  and  straw  pillow.  Another  room  seven  feet  square,  with 
ceiling  eight  feet  high,  was  occupied  by  the  woman  first  described. 
It  contained  no  bedstead  nor  bedding  of  any  kind,  the  occupant  sleep- 
ing on  the  floor  and  using  a  blanket.  "  At'times,"  said  the  attendant, 
"it  becomes  necessary  to  use  the  hand-cuffs  upon  her."  These  hiing 
on  a  nail  in  the  hall.  The  air  in  this  room  was  very  offensive.  Night 
buckets  were  used  in  these  rooms  as  well  as  in  the  main  building.  A 
stairway  leads  from  the  attendants'  room  to  the  attic.     At  the  north 


52  Report  on  the  Chroxic  Insane. 

end  is  a  room  in  which  are  two  wooden  bunks.  One  of  these  was  used 
at  night  by  an  inmate.  The  bedding  consisted  of  a  straw  tick,  cover- 
let and  blanket.  The  ventihiting  flue  from  below  opens  into  this 
room.  The  plastering  of  the  ceiling  was  nearly  off,  some  of  the  laths 
broken,  evidences  of  leakage  a]ii)arent,  the  open  sky  visible  in 
several  places  through  the  roof.  The  central  room  was  unfurnished. 
In  the  t^TO  south  rooms  the  i)lastering  had  mostly  fallen.  They  were 
at  the  time  of  visit  unoccupied.  The  attendant  said  :  "  They  are  used 
at  times  as  a  temporary  expedient  to  relieve  an  over-crowded  condition." 

A  small  yard  twonty-six  by  forty-two  feet  adjoins  this  building, 
inclosed  by  a  tight  board  fence  seven  feet  high.  This  yard  is  designed 
for  the  use  of  the  inmates,  and  communicates  with  the  ward  within 
by  a  door  which  is  kept  unlocked.  It  is  shaded  by  a  tree  with  seats 
around  the  base.     A  closet  with  box  beneath  occupies  one  corner. 

In  a  building  situated  in  the  rear  of  the  portion  called  the  "jail 
house,"  at  the  south-east  corner,  is  a  small  room,  eight  by  nine  feet  six 
inches  and  ceiling  eight  feet  high.  It  is  occupied  by  a  quiet,  paj'ing 
patient.  The  small  window  is  crossed  with  iron  bars.  A  stained 
wood  bedstead  of  French  pattern,  good  bed  and  bedding,  painted 
chair  and  stand,  looking  glass  and  framed  picture  on  the  wall,  com- 
prise the  furniture.  Clothing  hung  on  the  wall,  and  on  the  stand  was 
a  Bible  and  two  other  books  of  a  religious  character,  all  belonging  to 
the  patient. 

On  the  third  floor  of  the  old  poor-house  building  is  a  room  ten  by 
twenty-six  feet,  with  ceiling  eight  feet  four  inches  at  one  angle,  and 
three  feet  from  floor  at  the  otlier,  where  sleep  six  of  the  insane  who 
work  on  the  farm.  The  room  is  lighted  by  a  window  two  feet  by  one 
foot  six  inches,  and  another  three  feet  by  twenty-one  inches.  A  third 
window  of  similar  size  was  temporarily  boarded  up.  This  room  con- 
tained three  iron  bedsteads,  strap  iron  bottoms,  straw  ticks,  sheets, 
pillows,  quilts  and  blanket.  One  stool  was  in  the  room,  and  nails 
were  driven  in  the  wall  upon  which  to  hang  clothing. 

A  room  adjoining,  twelve  by  sixteen  feet,  with  ceiling  eight  feet 
six  inches  high,  and  plastered  walls,  contained  three  bedsteads  with 
bedding  similar  to  that  just  described,  also  a  stool.  Clothes  were  hang- 
ing from  nails  in  the  wall.  It  was  well  lighted,  and  separated  from 
the  male  dormitory  in  the  poor-house  department  by  a  door  with  open 
grating,  over  which  was  hinged  a  close  blind. 

Heating  and  ventilation. —  In  the  basement  under  the  main  asylum 
building  is  a  hard  coal-heating-furnace,  put  in  several  years  since, 
from  which  heating-pipes  pass  to  the  rooms  above.  The  furnace  sys- 
tem is  supplemented  by  stoves  when  needed. 

The  ventilation  is  mainly  accomplished  by  means  of  the  windows, 
and  is  insuflicient.  Circular  openings  about  six  inches  in  diameter 
are  cut  in  the  ceilings  of  some  of  the  upper  rooms  to  facilitate  ventila- 
tion. 

No  thermometers  are  used. 

Dietary. —  We  were  informed  that  the  insane  women  all  eat  in  their 
wards.  The  insane  farm  hands  eat  with  the  paupers  in  the  poor-house, 
and  the  others  in  the  men's  ward  of  the  asylum,  the  food  being  sup- 
plied from  the  poor-house  kitchen. 

There  is  no  diet  table.  The  keeper  prescribes  the  diet,  supervised 
by  the  physician. 


Report  on  the  Chroxic  Insane.  53 

The  table-ware  is  of  tin,  as  are  also  the  spoons.  The  insane  at  the 
pauper  table  use  crockery-ware  witli  ordinary  knives  and  forks. 

The  food  in  summer  for  breakfast  was  said  to  be  meat,  potatoes, 
bread  and  tea.  Dinner  includes  the  foregoing,  with  vegetables  in  their 
season,  twice  a  week,  comprising  onions,  beets,  cabbage,  beans,  etc. 
Supper  consists  of  bread  and  milk  or  mush  and  milk.  In  winter  the 
diet  is  said  to  be  the  same. 

There  is  no  special  diet  for  the  sick. 

Clothing. —  In  summer,  the  men  wear  denim  shirts,  satinet  pants 
and  vest,  denim  overfrock,  blue  or  brown,  wool  or  straw  hat,  cotton 
socks,  and  boots ;  winter,  denim  shirts,  woolen  coat,  vest  and  pants, 
woolen  socks,  and  boots.  Those  who  work  in  the  woods  wear  drawers 
and  wrappers. 

The  women  wear  in  summer,  calico  dress,  cotton  underwear,  cotton 
skirt,  cotton  stockings  and  shoes,  and  in  winter,  the  same,  with  more 
under-clothes. 

Bedding. —  The  bedsteads  throughout  are  mainly  of  flat  iron,  with 
hoop  iron  slat  bottoms,  upon  each  of  which  was  a  straw  tick,  two  sheets, 
feather  pillow,  tufted  quilt,  and  a  counterpane,  removed  at  night. 
In  the  men's  department  are  three  wooden  bedsteads  of  the  Willard 
asylum  pattern,  and  the  usual  bedding. 

Employment. —  Some  of  the  men  are  employed  in  farm  work,  such 
as  plowing,  mowing,  harvesting,  gardening,  etc.  Cutting  wood  is  all 
done  by  the  insane.  The  keeper  said  :  "  The  best  seed  sower  on  the 
farm  is  one  of  tlie  insane."  They  are  not  employed  in-doors.  The 
women  do  housework;  three  work  in  the  kitchen.  Four  of  the  men 
do  a  fair  day's  work,  and  seven  a  partial  day's  labor.  Two  of  the 
women  do  a  fair  day's  labor,  and  one  a  partial  day's  work. 

The  keeper  said:  "Four  men  do  three-fourths  of  a  day's  work  each, 
and  the  others  not  over  one-fourth.  Two  of  the  men  last  winter 
chopped  ten  cords  of  wood  in  one  day.  Two  women  do  three-fourths 
of  a  day's  work,  and  the  rest  about  one-fourth."  Nothing  is  done  to 
prevent  the  insane  from  overworking. 

The  keeper  said  :  "  The  influence  of  labor  is  highly  beneficial.  They 
are  more  quiet,  and  sleep  and  rest  better.  One  man,  if  he  lays  still 
for  three  days,  will  be  raving." 

Restraint. —  The  restraining  appliances  consist,  it  is  said,  of  "one 
muff,  two  pairs  of  handcuffs,  and  one  pair  of  leg-irons, worn  by  a  patient 
to  prevent  him  from  running  away."  The  keeper  prescribes  the 
restraint;  confinement  in  dungeons,  or  dark  cells,  is  not  resorted  to. 
"  If  patients  are  unmanageable,"  said  the  keeper,  "  we  shut  them  in 
their  rooms  as  the  only  means  of  punishment." 

Water  supply. —  The  poor-house  and  insane  asylum  are  supplied 
with  water  from  two  wells  at  the  house,  one  being  located  five  feet 
east  of  the  asylum,  and  about  ten  feet  north  of  the  poor-house  build- 
ing. There  are  also  two  wells  at  the  barns.  The  keeper  said  :  "  Two 
of  the  wells  are  inexhaustible,  and  two  have  sometimes  failed." 
There  are  three  underground  cisterns  for  rain  water.  There  is  also  a 
zinc-lined  oblong  tank  in  the  attic  for  receiving  the  water  from  the 
roof  of  the  asylum  building.  The  bath  is  supplied  with  cold  water 
by  means  of  pipes  and  faucets.  No  special  provision  is  made  against 
fire. 
Sewerage. —  One  of  the  sewers  starts  ten  feet  from  the  poor-house 


54  Repobt  on  the  Chronic  Insane. 

well.  It  is  a  wooden  box  laid  underground  for  a  distance  of  eight 
or  nine  rods,  and  discharging  into  an  open  ditch  in  the  garden.  One 
from  the  east  end  of  tlie  poor-house,  near  the  paupers'  kitchen,  dis- 
charges into  tlie  same  ditch.  One  from  the  wash-house  is  made  of  plain 
brick  tile,  six  inches  in  diameter,  and  discharges  into  an  adjoining  pas- 
ture.    None  of  tliese  sewers  have  traps. 

Oeneral  observations. —  The  sexes  are  separated  whilst  in-doors,  also 
when  out.  Tiiere  is  no  special  chissilication,  except  to  keep  some  of 
the  violent  and  excited  by  themselves.  There  is  no  special  provision 
for  ci)ile])tics  or  idiotic.  There  are  no  insane  epileptics.  Idiots  are  not 
sepai-ated  from  the  insane. 

No  in-door  nor  out-door  amusements  are  provided,  except  checkers. 

The  clotliing  of  the  insane  is  washed  separately  from  that  of  the 
sane  paupers,  and  the  men  and  women's  clothing  are  kept  separate. 
It  is  all  washed  at  the  wash-house. 

There  are  six  paying  patients  residents  of  tlie  county  —  three  men 
and  three  women.  The  price  charged  for  maintenance  is  from  $2  to 
$3  per  week.  A  soldier  pays  $72  per  year.  One  patient  from  outside  the 
county  pays  $3  per  week.  Those  paying  over  $3  per  week  board 
from  the  keeper's  table,  and  those  at  %'i  from  the  poor-house  table. 

During  the  past  year  a  frame  wing,  sixty  by  twenty-eight  feet,  has 
been  built  in  connection  with  the  main  i)Oor-house  building  at  the 
left.  It  is  two  stories  high  with  shingled  roof.  In  this  addition  are 
two  rooms  to  be  used  for  the  sick  —  one  for  the  men  eighteen  by 
twenty  feet,  and  one  the  same  size  for  women  —  and  in  these  rooms  it 
is  proposed  to  treat  tlie  insane  when  sick.  On  the  upper  floor  is  a 
large  room  intended  for  chapel  purposes.  Under  the  chapel  is  an  oflice 
for  the  superintendents,  a  kitchen,  buttery,  and  wood-shed. 

The  inspection  of  the  institution  was  made  by  Commissioner  Letch- 
worth  September  7,  1881. 

Jefferson  County. 

The  poor-house  of  this  county  is  situated  on  the  rocky  banks  of  the 
Black  river,  a  mile  and  a  half  from  Watertown,  with  which  place  it  is 
in  telephonic  communication.  The  building  faces  the  east,  and  stands 
a  little  distance  from  the  highway,  with  an  intervening  shaded  park  of 
several  acres.  In  front  of  tlie  house  is  a  small  flower-garden  inclosed 
by  a  picket-fence,  while  the  river  flows  close  by  the  rear. 

The  main  building  of  the  poor-house  is  brick,  two  stories  high,  with 
dormer  windows  and  basement,  the  floor  of  the  latter  being  about  one 
foot  below  grade  in  front  and  above  grade  in  rear.  It  forms  the 
residence  of  the  superintendent,  oflicers,  etc. 

The  left  wing,  two  stories  high,  about  eighty-five  feet  long,  and 
a  foot  and  a  half  below  grade  in  front,  is  occupied  by  sane  paupers. 
The  right  wing,  two  stories  high,  with  basement,  is  allotted  to  the 
insane.     The  basement  floor  is  above  grade  in  the  rear. 

The  roof  of  each  wing  is  of  sheet  iron,  painted.  The  front  and 
rear  windows,  including  the  front  basement,  have  outside  iron 
guards. 

Officials  and  employes. —  This  county  has  one  superintendent  of 
the  poor,  who  is  also  keeper.  The  present  incumbent  has  held  the  posi- 
tion five  years.    The  compensation  allowed  for  himself  and  wife  is  $800 


Report  on  the  Chronic  Insane.  55 

per  yem'  aud  living.  A  man  to  work  on  the  farm  at  $24  a  month,  and  a 
wornan,  once  an  inmate,  at  11,50  per  week  are  employed.  A  woman 
has  also  been  usually  employed  at  ^2  per  week  to  take  charge  of  the 
bakery.     This  place  was  vacant,  however,  at  the  time  of  the  visit. 

Tiie  insane  department  is  under  the  charge  of  a  keeper,  whose  wife 
acts  as  matron.  The  , compensation  of  both  is  $450  per  year  and  liv- 
ing. He  has  held  the  situation  eight  and  a  half  years.  A  female  at- 
tendant is  also  employed  at  $3  per  week.  No  pauper  labor  is  used  in 
the  insane  department. 

Medical  supervision. —  The  county  physician  resides  at  Watertown. 
He  is  appointed  by  the  board  of  supervisors  and  is  required  to  visit 
the  asylum  once  a  day,  and  oftener,  if  necessary.  His  compensation 
is  $350  per  annum,  for  which  he  is  expected  to  furnish  all  needed 
medicines. 

General  description.—  The  wing  building  for  the  insane  is  of  brick 
one  hundred  and  five  by  thirty-eight  feet.  The  basement  contains 
the  kitchen,  and  dining-room  for  each  sex,  bath-room,  clothes-press, 
bake-room,  laundry  and  family  kitchen.  The  sitting  room  and  dor- 
mitories are  on  the  two  upper  floors.  There  are  two  flights  of  stair- 
ways in  the  building. 

In  the  basement  hall  the  windows  contained  painted  boxes  filled 
with  flowers.  The  first  room  at  the  right,  a  long  apartment,  was  used 
as  a  store-room,  and  also  for  drying  clothes  in  stormy  weather.  It  was 
filled  with  clean  clothing,  neatly  folded  or  hung.  Clothes  were  being 
dried  there  at  the  time  of  visit.  The  air  was  damp  aud  disagreeable. 
Adjoining  this  was  the  bake-room.  The  next  was  used  as  a  bath- 
room. Further  on  was  the  laundry,  next  to  which  were  the  dining- 
rooms.  The  tables  in  the  latter  were  laid  for  supper,  with  tea,  bread 
and  butter.  Later  ^qyq  seen  twenty-nine  women  at  the  supper  table. 
Their  dresses  were  clean  and  hair  neatly  combed.  None  had  their 
hair  cut  close.  In  the  male  dining-room  were  seven  men  partaking 
of  bread  and  butter  with  tea.  A  paid  assistant  was  present.  In  both 
dining-rooms,  were  stained  and  varnished  deal-tables  and  benches, 
crockery  plates  and  steel  knives  and  folks.  Beyond  these  rooms,  was 
the  asylum  kitchen,  which  in  its  appointments  and  orderly  arrange- 
ment, indicated  good  housekeeping. 

On  the  second  floor,  adjoining  'the  apartments  for  attendants,  is  a 
goodly-sized  room,  formerly  called  the  "fool's  room,"  but  now  known 
as  the  ''second  department."  At  the  time  of  inspection  it  was  occu- 
pied by  four  insane  women  and  one  idiot.  On  entering  this  apartment 
the  first  object  that  met  the  eye  was  the  white  and  rounded  form  of  a 
woman  entirely  nude.  She  was  sitting  in  a  square  painted  box  that 
came  to  her  armpits.  The  box  was  enlarged  in  front  to  allow  suffi- 
cient space  for  her  knees  in  the  sitting  posture,  and  also  lowered  in  front 
to  a  shelf  on  which  she  received  her  food.  Her  face  was  pale,  hair 
short,  eyelids  red  and  eyes  sunken.  The  apartment  seemed  cold.  The 
keeper,  In  explanation,  stated  that  she  was  an  idiot ;  that  clothing 
seemed  to  torture  her  and  cause  her  to  scream,  so  that  it  was  found 
impossible  to  keep  her  properly  clad.  She  was  designated  the  "idiot 
girl,"  although  her  age  was  given  as  between  forty  and  fifty  years.  It 
was  further' stated  that  she  was  brought  to  the  asylum  about  a  year 
ago,  in  a  box  similar  to  that  in  which  she  is  now  confined. 

Of  the  other  women  in  the  room,  one  was  sitting  on  the  floor,  eating 
8 


oG  Report  on  the  Chronic  Insane. 

ht'i*  supptT;  luiother  was  restrained  by  a  muff,  and  a  third  was  iu  an 
exciit'd  condition. 

Adjoinin;f  this  department  is  thi-  mule  ward,  which  contains  seven 
rooms.  All  have  paneled  doors,  excepting  one  which  has  npright 
slats.  Over  the  doors  were  good-sized  transoms  with  horizontal  rods. 
The  ceilings  are  ten  feet  high.  The  rooms  are  furnished  simply  with 
bedstead,  bedding,  and  night  bucket. 

The    sitting-room  has  two  windows  with  mnslin  shades,  and  was 

furnished  with  comfortal)le  chairs.     .Some  pictures  hung  upon  the  wall. 

The  sitting-room  of  the  womeii's  ward  was  larger  and  was  provided 

with  window  curtains,  rocking  and  other  chairs,  also  several  pictures. 

The  bed-rooms  adjoining  contained  clean  and  comfortable  beds. 

On  the  third  floor  was  a  large  sitting-room  for  female  patients,  hav- 
ing pictures  on  the  walls,  muslin  window  curtains,  rocking-chairs, 
and  a  goodly  number  of  otiier  chairs.  In  an  associate  dormitory  were 
ten  beds. 

The  women's  wards  were  supplied  with  upholstered  lounges  or 
settees. 

The  women's  yard,  connected  witli  the  wards  by  an  unlocked  door, 
is  L  shaped,  one  hundred  and  four  by  altout  one  hundred  feet,  and 
surroun<led  by  a  close  matched  board  fence  ten  feet  high,  with  serrated 
top.  A  small  portion  was  grassed,  the  remainder  planted  with  maples, 
over  thirty  in  number,  aflbrding  a  dense  shade.  It-  is  provided  with 
seats  and  closets.     Several  women  were  in  the  yard. 

With  free  communication  to  the  malj  ward  is  a  yardaboutthe  same 
length  as  the  other  and  forty-six  feet  wide.  It  also  is  grassed  and 
shaded  with  maples  and  pines.  Only  two  men  were  in  this  yard  ;  one 
wearing  shoes  and  the  other  barefooted. 

Heating (171(1  ventilafi(m. —  The  building  is  heated  by  steam,  with  di- 
rect radiation.  Ventilating  flues  from  the  various  wards  and  rooms 
open  into  the  attic,  to  which  air  is  admitted  under  the  eaves. 

Bathing  arrangements  and  laundry. —  The  patients  are  bathed,  it 
was  said,  once  a  week,  and  oftener  if  necessary.  For  this  purpose  com- 
mon wash-tubs  are  placed  in  a  room  adjoining  the  laundry  in  the 
basement. 

The  laundry  is  supplied  with  hot  and  cold  water.  Washing  is  done 
by  hand.  In  summer  the  clothes  are  dried  in  the  yard,  and  within 
doors  during  winter. 

Dietary. —  The  institution  has  no  printed  dietary.  The  food  sup- 
plied was  said  by  the  keeper  to  be  as  follows :  Breakfast,  potatoes, 
beef,  generally  boiled,  unsweetened  tea,  without  milk,  hop-yeast  bread, 
and  butter,  when  no  meat  is  used  ;  dinner,  the  same,  except  that  cof- 
fee is  supplied  with  sugar  and  milk,  twice  a  week,  in  place  of  tea,  pork 
and  beans  once  a  week,  fried  pork  once  a  week,  and  tlsh  on  Fridays  ; 
supper,  in  summer,  bread  and  butter  twice  a  week,  with  clear  tea. 
bread  and  apple-sauce  with  tea,  and  bread  and  milk  twice  a  week  with- 
out tea.  Only  two  meals  are  served  on  Sundays,  and  also  in  winter 
from  the  20th  of  October  to  the  20th  of  April.  These  two  meals  are 
similar  to  breakfast  and  dinner,  except  that  more  vegetables  are 
added  for  dinner  and  frequently  for  breakfasr.  Quite  often  pickled 
beets  are  added  for  l)reakfast  with  turnips  and  cabbage,  besides  potatoes 
for  dinner.  Green  corn,  peas,  and  string  beans  are  served  in  their 
season  for  dinner.  Fresh  fruit  is  given  as  a  treat  occasionally,  but 
not  regularly. 


Report  on  the  Chronic  Insank.  57 

Clothing. — The  following  was  given  as  the  clothing  provided  for 
patients:  In  summer,  for  men,  a  white  cotton  shirt,  cottonade  pants, 
vests  and  frock  coats,  straw  hats,  slioes  and  cotton  socks  ;  many  go 
barefooted.  *'It  is  almost  impossible,"  the  keeper  remarked,  "with 
one  or  two  exceptions,  to  keep  any  thing  on  tlieir  feet."  In  the  winter 
the  clothing  is  the  same,  except  that  heavier  cottonade  goods  are  worn, 
and  boots  in  place  of  shoes,  with  woolen  socks  and  heavy  clotli  caps. 

The  women  in  summer  are  provided  with  cotton  underwear,  cotton 
under-skirt,  and  calico  dress.  We  use  heavy  striped  goods  for  some; 
those  who  work  wear  drawers,  but  a  great  many  will  not  wear  these. 
Shoes  and  stockings  are  supplied  to  those  who  will  use  them,  also  a 
calico  sun-bonnet.  In  winter  an  nnder-waist  is  furnished,  also  a 
quilted  skirt.  Nearly  all  are  then  compelled  to  wear  shoes  and  stock- 
ings.    Those  patients  who  will  not  wear  them  are  kept  in  the  house. 

Bedding. — Wooden  bedsteads  are  in  use,  of  the  Willard  asylum  pat- 
tern, having  iron-strap  bottoms.  The  bed  consists  of  straw  tick,  with 
feather  pillow,  two  sheets,  one  bed-quilt  in  summer;  and  in  winter,  it 
was  said,  two  or  more  are  used,  if  necessary.  About  one-fourth  of  the 
beds  are  double. 

Employment. — There  is  no  employment  for  the  men  in-doors. 
There  are  nine  who  perform  a  partial  day's  labor.  One  works  outside 
about  the  stables,  and  on  the  farm.  The  keeper  thinks  the  labor  of 
this  man  worth  SlOO  a  year  to  the  institution.  He  works  without 
supervision,  and  can  bo  sent  anywhere. 

The  women  are  engaged  under  the  direction  of  the  attendant,  mostly 
at  housework  or  sewing.  It  was  said  that  ten  of  them  perform  a  fair 
day's  labor.  The  keeper  thinks  three  hired  women  would  do  the  work 
of  these  twenty.  Two  men  disposed  to  overwork  are  required  to  be 
guarded  in  this  respect.  The  keeper  thinks  when  insane  men  want 
to  work,  labor  is  benelicial,  but  he  does  not  favor  compulsion. 

Restraint. — Two  muffs,  two  pairs  of  hand-cuffs,  and  one  pair  of 
shackles  were  said  to  be  the  restraining  appliances  in  use.  These 
are  preferred  by  the  keeper,  but  disapproved  of  by  the  physician. 
The  doctor  thinks  a  couple  of  restraining  chairs  and  a  few  cribs  are 
needful,  also  that  the  number  of  attendants  is  insufficient.  At  the 
time  of  visit  only  one  person  was  found  restrained  by  hand-cuffs. 
Ordinary  rooms  are  used  for  the  seclusion  of  patients,  the  doors  of 
which  they  sometimes  break  down.  The  restraint  is  said  to  be  regu- 
lated by  the  physician,  and  but  little  practiced. 

There  are  no  dark  rooms  nor  cells  in  the  institution.  The  keeper 
says  •'punishment  is  not  inflicted  upon  the  insane  under  any  circum- 
stances. I  do  not  think  there  is  any  sense  in  punishing  an  insane  per- 
son. The  former  custom  of  punishing  is  now  abolished.  It  is  in- 
tended to  keep  only  the  mild  cases  here,  and  send  the  troublesome  to 
Willard  asylum." 

Water  supply. — By  means  of  a  steam  pump  the  water  is  forced 
through  a  one  and  a  quarter  inch  pipe  into  a  reservoir  on  the  third 
floor,  having  a  capacity  of  a  hundred  barrels. 

The  keeper  said  :  "  Last  winter  the  water  in  the  river  was  two 
degrees  below  fret-zing  point,  and  we  could  not  pump  it,  and  had  to 
carry  it  in  pails  from  the  river.  This  happened  but  once  in  the  three 
years  the  pipes  have  been  in  use.  The  pumps  are  run  with  only 
twelve  pounds  pressure  of  steam." 


58  Keport  on  the  Chronic  Insane. 

The  sewers  of  Watertown  empty  into  the  river  one  and  a  half  mile 
above  the  poor-house. 

The  river  water  is  used  for  cooking  and  general  purposes.  The 
water  for  drinking  is  supplied  from  a  flowing  well  of  five-inch  bore 
drilled  fifty-five  feet  in  the  solid  rock.  The  nearest  closet  is  distant 
one  hundred  and  fifty  feet.  The  nearest  sewer  is  seventy-one  feet  dis- 
tant, and  is  made  of  six-inch  ghized  socket-tile  with  cemented  joints. 

Seiuerage. —  Slops  are  emptied  into  iron  sinks  witii  traps,  connecting 
with  a  six-incli  socket  drain,  with  cemented  joints.  The  glazed  tile 
extends  but  a  short  distance  in  rear  of  the  building,  and  tlien  dis- 
charges into  an  open  sewer.  In  ordinary  seasons  this  is  covered  a 
portion  of  the  time  with  water  ;  when  otherwise  it  must  be  offensive. 
In  tiie  yards  are  common  privies  with  wooden  vaults,  said  to  be 
cleaned  once  a  month,  or  every  six  weeks,  as  required. 

Farm  and  f/arden. —  The  poor-house  farm  comprises  one  hundred 
and  seventy-six  acres  ;  about  forty-five  acres  are  meadow  land,  one  hun- 
dred acres  pasture,  fifteen  or  twenty  acres  waste  land.  There  is  no 
woodland.  The  live  stock  consists  of  fourteen  milch  cows  and  three 
horses;  none  of  the  milk  is  sold.  Some  butter  was  made  in  the 
month  of  June.  A  small  crop  of  oats,  a  little  corn,  and  about  five 
acres  of  potatoes  were  planted  ;  about  two  acres  are  appropriated  as  a 
garden,  for  the  raising  of  vegetables  for  the  inmates.  The  farm  has 
a  small  orchard  of  apples. 

General  observations. —  Practically,  there  is  no  classification,  except 
as  to  the  separation  of  a  few  of  the  more  disturbed  from  the  rest.  The 
sexes  are  separated  while  in  and  out  of  doors.  There  is  no  special 
provision  for  epileptics. 

The  insane  are  registered  in  the  poor-house  office,  separately  from  the 
other  inmates.  Certificates  of  insanity  are  there  filed.  Some  of  those 
examined  did  not  show  whether  the  cases  were  acute  or  chronic.  The 
physician  thinks  that  many  of  the  certificates  arc  filled  up  very  im- 
perfectly, and  that  they  should  be  more  full,  embracing  a  previous 
medical  history  of  the  case.  He  stated  that  one  of  the  reasons  given 
in  a  certificate  for  the  patient  being  insane  was,  that  he  "  was  a  rav- 
ing maniac."  He  thought  the  medical  profession  of  the  county 
"  manifested  no  particular  interest  in  the  institution."  Many  visitors 
came  from  motives  of  curiosity. 

The  county  journals,  as  well  as  illustrated  papers,  and  other  read- 
ing matter  .are  supplied.  Visitors  engaged  in  missionary  work  in  the 
poor-house  furnish  some  books  to  the  inmates.  At  the  time  of  inspec- 
tion, a  reverend  gentleman  from  Watertown,  and  two  ladies  were  for 
several  hours  engaged  in  this  work.  They  had  })reviously,  on  different 
occasions,  distributed  newspapers,  as  well  as  some  forty  or  fifty  Bibles 
and  prayerbooks. 

Paying  patients  are  not  now  received.  There  were,  however,  one 
man  and  two  women  for  whom  the  county  received  $1  per  week  each. 
Two,  it  was  said,  were  sent  to  Rome,  for  whom  their  friends  were  able 
to  pay.  The  amount  received  from  paving  patients  for  the  year  wai 
$374. 

The  examination  of  this  institution  was  made  by  Commissioner 
Letch  worth,  October  13,  1881. 


Repokt  on  the  Chronic  Insane.  59 

Livingston  County. 

The  Livingston  county  poor-house  is  located  about  one  mile  east- 
ward from  the  village  of  Geneseo,  and  two  miles  from  the  station  on 
the  Corning  branch  of  the  New  York,  Lake  Erie  and  Western  rail- 
road . 

The  site  is  somewhat  retired,  standing  about  eighty  rods  back  from 
the  roadway.  Directly  in  front  of  the  buildings  is  an  inclosurc  about 
fifty  feet  in  width,  phmted  with  flowers  and  shrubbery.  Between  this 
and  the  highway  is  a  meadow,  with  a  cornOeld  at  the  left. 

The  poor-house  farm  comprises  one  hundred  and  fifty-one  acres  of 
land,  of  fair  quality,  comparing  favorably  with  other  farms  in  the 
vicinity. 

Officials  and  employes. —  The  insane  department  is  directed  by  the 
superintendent  of  the  poor,  who  also  acts  as  keeper  of  the  poor-house 
proper,  and  whose  compensation  is  fixed  by  the  board  of  supervisors 
at  81,000  per  annum.  He  is  required  to  live  at  the  poor-house.  His 
wife  acts  as  matron,  and  is  paid  at  the  rate  of  $6  per  week,  while  his 
son  discharges  the  duties  of  book-keeper  and  general  assistant  for  a 
remuneration  of  825  per  month,  including  board  and  lodging. 

Two  men,  one  on  each  floor,  are  employed  in  the  male  department, 
each  sleeping  in  his  own  ward  at  night.  One  of  these  is  required  to 
be  in  the  asylum  at  all  times,  the  other  goes  out  with  the  field  hands. 
The  compensation  of  these  assistants  is  825  and  830  a  month,  respect- 
ively, with  board. 

In  the  female  department  there  are  also  two  attendants,  one  on  each 
floor,  who  sleep  in  the  wards.  They  each  receive  84  per  week,  with 
board.  Female  cooks  are  employed  in  the  kitchens  of  each  depart- 
ment, one  being  paid  84  per  week  and  the  other  83.  In  reference  to 
compensation  the  supei'intendent  said:  "  We  pay  good  wages  and  re- 
quire good  service." 

Medical  S'i/pervisio}i. —  The  l)oard  of  sujjervisors  appoint  the  physi- 
cian of  the  asylum.  The  present  incumbent  resides  at  Geneseo.  His 
compensation  is  8250  per  year,  the  stipulation  being  that  he  furnish 
the  medicines.  He  visits  the  institution  two  or  three  times  a  week, 
and  oftener  if  required.  No  extra  allowance  is  made  for  services  in 
special  cases. 

The  physician,  who  has  an  office  and  a  small  dispensary  in  the  poor- 
house,  prescribes  the  medicines  when  called  upon.  The  matron  also 
occasionally  prescribes  for  patients. 

The  sick  are  treated  in  their  rooms.  There  is  no  consulting  {jhysi- 
cian,  but  if  needed,  one  is  called.  The  medical  profession,  it  was 
stated,  "take  no  special  interest  in  the  poor-house.  Occasionally  a 
physician  will  make  an  inquiry  concerning  some  patient  formerly  un- 
der his  charge." 

General  description.—  The  department  for  the  insane,  sixty-five  feet 
west  from  the  poor-house,  consists  of  two  brick  l)uildings.  The  first,  a 
two-story  and  basement,  was  built  in  1869,  and  has  a  large  brick  ad- 
dition, built  in  1873.  Further  west  some  forty-five  feet  is  another 
brick  building,  two  stories  in  height,  with  basement,  built  in  1879, 
at  a  cost  of  about  814,000,  including  furniture  and  heating  apparatus. 

The  basement  in  the  old  part,  used  as  a  general  kitchen  for  the 
men's  department,  measures  seventeen  feet  by  forty-six,  and  is  eight  feet 


60  Report  on  the  Chronic  Insane. 

high.  It  has  a  brick  floor.  Here  was  found  the  usual  furniture,  also 
a  hvrgc  kitchen  range  burning  hard  coal,  and  a  cauldron  stove  used  on 
wash  (lays  for  boiling  clothes.  Adjoining  the  kitchen  is  a  scullery  and 
a  room  for  the  temporary  keeping  of  soiled  garments. 

In  rear  of  the  kitchen  is  the  dining-room  for  men,  twelve  feet  by 
fifty  feet.  It  is  lighted  by  two  windows  having  iron  gratings.  In 
one  corner  of  the  floor  of  this  room  is  a  sink  with  perforated  plate. 
A  large  store-room  connects  this  dining-room  and  that  of  the  attend- 
ants with  the  kitchen. 

In  the  north  end  of  the  building  is  a  hall  measuring  eight  feet  by 
twenty-six  feet,  and  eight  feet  high.  The  floor  is  brick  laid  through- 
out. A  sink  in  this  floor,  having  perforated  plate  with  bell-trap  is 
connected  with  the  sewer. 

The  cells,  Seven  in  number,  open  into  this  hall  —  three  on  one  side, 
and  four  on  the  other,  averaging  nine  feet  ten  inches  by  five  feet  nine 
inches  in  size.  The  doors  of  these  cells  are  two  feet  four  inches  wide, 
and  arc  constructed  of  vertical  iron  rod.s,  set  in  an  iron  frame  two 
inches  apart.  Tiiey  are  secured  when  closed  by  a  heavy  padlock. 
Each  cell  has  one  window  twenty-two  by  forty-two  inches,  protected 
by  iron  grating  of  flat  bars. 

The  furniture  consists  of  an  iron  bedstead,  a  straw  tick,  a  feather 
pillow,  sheets,  two  blankets  and  a  counterpane  for  day  use,  also  a 
night-bucket. 

In  one  of  the  cells  was  a  restraining-chair,  with  open  seat,  stocks  for 
the  legs,  and  body-sti'aps,  also  muffs,  waist-belt  and  wristlet  bauds.  In 
another  hanging  on  the  door  was  a  pair  of  manacles.  The  keeper 
said,  "  These  rooms  are  used  only  for  restraint.  " 

Upon  the  first  floor  above  the  dining-room  is  a  hall  used  on  Sundays 
for  religious  services,  and  occasionally  in  the  winter  for  dancing. 
The  keeper  said,  "We  have  a  good  fiddler  in  the  asylum,  and  fre- 
quently have  dances  with  the  attendants  and  insane  men  and  women 
together.  " 

The  windows  in  this  hall  are  grated.  Benches  are  provided  for  one 
side  as  well  as  for  the  end,  while  on  the  other  side  is  a  wooden  settee. 
The  walls  are  relieved  i)y  four  framed  prints.  The  hall  is  heated  by  a 
register  placed  in  the  floor,  and  the  heat  for  the  upper  story  is  carried 
by  pipes  through  this  hall. 

Several  small  rooms,  occupied  by  the  cooks  and  other  domestics, 
open  into  tliis  hall.  The  windows  in  them  are  narrow,  containing  but 
four  panes  of  gla.ss,one  al)ove  the  other,  each  measuring  four  and  one- 
fourth  by  sixteen  inches.  Each  room  has  a  circular  opening  for  ventila- 
tion over  the  window  live  inches  in  diameter.  On  the  north  side  of  the 
hall  are  three  small  rooms  of  equal  size.  One  is  used  for  storing  men's 
clothing  ;  the  others  are  occupied  by  two  women  patients  of  the  quiet 
class,  wlio  assist  in  the  kitchen. 

A  hall  twelve  feet  four  inches  by  thirty-four  feet  three  inches  leads 
northward.  It  is  divided  on  the  east  by  two  rooms,  now  u«ed  by  the 
attendants  and  hired  man.  and  a  hall  stairway.  The  furniture  of  this 
hall  consists  of  a  wooden  chair,  a  round  stand,  a  spittoon,  and  an  orna- 
mental advertising  card  on  the  wall.  Between  the  doors  of  the  rooms 
were  placed  wall  seats.  The  heat  is  supplied  through  a  register  from 
the  flue  below.  Six  rooms  originally  occupied  the  west  side  of  the 
hall.     These  the  present  keeper  converted  into  three.     Each  room  as 


Report  on  the  Cheonic  Insane.  61 

now  arranged  has  two  windows  five  feet  seven  inches  by  twenty-one 
inches,  with  outside  wooden  sash  provided  with  bolts. 

The  doors  are  provided  with  grated  transoms.  One  of  these  rooms 
was  occupied  by  a  male  patient.  Its  furniture  consisted  of  an  iron 
bedstead,  a  straw  tick,  two  sheets,  two  featlier  pillows,  and  a  counter- 
pane, a  deal  table,  a  Bible,  and  some  illustrated  papers.  A  spray  of 
flowers  in  water  was  also  observed.  There  was  no  chair.  The  patient's 
clothing  hung,  some  from  cords  and  some  from  hooks.  'J'he  bed  was 
clean  and  well  made,  the  window  clean  and  room  in  order.  The 
other  two  rooms  had  no  furniture  except  beds  of  a  similar  pattern  to 
the  above. 

At  the  east  end  of  the  old  building,  on  the  tirst  floor,  is  a  large  hall 
with  room  adjoining,  whicii  has  been  converted  into  a  hosi)itai  ward 
for  both  sane  and  insane.  It  was  formerly  one  of  the  cell  wards  of  the 
insane  department.  The  attendant  here  was  an  insane  pauper.  A 
dark  flight  of  steep,  narrow  stairs  leads  to  the  floor  above. 

On  the  second  floor  of  the  west  wing  is  a  hall  with  two  windows  at 
the  end,  heated  by  a  register.  Five  small  rooms  and  one  double 
room  open  into  this  hall.  The  small  rooms  are  four  feet  eight  inches 
by  eight  feet  two  inches,  windows  narrow  and  ventilation  through  the 
ceiling.  The  doors  are  double,  secured  by  a  bolt,  and  furnished  with 
diamond-shaped  apertures,  four  inches  in  diameter.  Above  the  door 
and  of  the  same  width  is  an  opening  secured  by  three  wooden  bars. 

The  ceiling  is  ten  feet  two  inches  high.  The  rooms  on  the  oppo- 
site side  of  the  hall  are  six  feet  four  inches  and  eight  feet  two  inches. 
They  have  the  same  arrangement  of  windows  and  ventilation.  The 
hall  proper  was  furnished  with  wall  benches,  a  stand  upon  which 
illustrated  and  other  papers  were  noted,  three  wooden  chairs,  a  deal 
table  and  spittoon. 

In  the  north  hall  also  changes  have  been  made.  Six  rooms  opening 
into  this  hall  now  occupy  the  space  formerly  divided  into  ten  cells. 
These  rooms  are  used  as  sleeping  apartments,iour  being  double  and  two 
single.  The  beds  and  bedding  are  similar  to  those  already  described. 
One  of  the  rooms  had  a  rug  which  was  the  gift  of  friends.  The  hall 
itself  was  without  chaiis,  and  its  walls  were  bare. 

The  ne20  building. —  This  is  occupied  by  women.  It  is  connected 
with  the  old  building  by  a  covered  porch  two  stories  high,  latticed 
above  and  closed  below. 

On  the  first  floor  a  long  hall  extends  the  entire  length  of  the  build- 
ing, and  is  intersected  in  the  center  by  another.  The  windows  which 
are  located  in  the  west  end  are  of  double  sash,  each  containino- 
twelve  panes  of  glass  six  by  eighteen.  The  frame  is  of  wood,  with 
iron  divisions  and  suspending  weights.  Large  chromos  were 
noticed  on  the  walls.  The  floors  were  bare  and  the  furniture  con- 
sisted of  oak  settees  and  a  plaster  vase  with  flowers.  Six  steam  radi- 
ators placed  in  different  parts  of  the  building  supplied  heat. 

The  occupied  rooms  were  furnished  with  iron  bedsteads  and  beds 
similar  to  those  already  described,  also  rocking  chairs.  The 
furnishing  in  some  instances  was  brightened  with  articles  suggestive 
of  home  life. 

The  bath-room,  supplied  with  hot  and  cold  water,  contained  wash- 
stand  with  stationary  bowls  and  water-closet  conveniences. 

A^  store-room,    south  of  the  hall,  is  shelved  on  two  sides,  one  for 


62  Report  os  the  Chronic  Insane. 

clothing,  the  other  for  medicines  and  articles  sent  by  friends.    Dresses 
of  i)atieiits  hung  from  wardrobe  hooks  in  the  wall. 

The  attendants'  room  is  on  the  south-east.  It  is  comfortably  fur- 
nished. 

The  second  floor  is  a  counteii^art  of  the  first  in  dimensions,  arrange- 
ments and  furnishing.     It  contained  fourteen  i)atiL'nts. 

In  the  attic  on  the  north  side  are  two  rooms  recently  finished  with 
dormer  windows.  Tiiey  are  reserved  for  filthy  patients.  One  of  these 
apartments  was  occupied  by  a  blind  insane  woman.  It  was  furnished 
with  a  bedstead,  bedding,  rng,  chair  and  stand.  The  door  was  bat- 
tened.    There  was  a  fan-light  above  but  no  ventilation. 

The  basement,  in  the  south-east  corner,  comprises  a  good  sized 
kitchen  provided  with  necessary  kitchen  appurtenances,  including  a 
large  range.  A  pantry  adjoins  on  the  west  and  is  supplied  with 
crockery  and  other  table  ware. 

At  the  west  end  of  the  building  was  found  a  shoemaker's  bench  and 
"kit."  'J'he  shoemaker  is  a  pauper,  and  besides  working  at  his  craft 
attends  to  the  steam  boiler. 

The  coal  for  the  boiler  is  conveniently  stored  near  the  shoemaker's 
shop. 

In  this  part  of  the  building  is  a  pump  for  supplying  water  to  the 
steam  boiler  and  also  for  forcing  it  up  to  the  tanks  in  the  attic. 

The  bath-rooms  in  the  building  are  of  an  improved  pattern,  and 
are  supplied  with  hot  and  cold  water. 

The  water-closets  have  automatic  seats. 

There  are  no  special  work-rooms  in  the  asylum.  The  women  work 
in  the  several  wards. 

Directly  in  the  rear  of  the  insane  asylum  are  the  yards.  That  of 
the  men's  department  is  one  hundred  and  eight  feet  by  one  hundred 
and  sixty-five  feet,  surrounded  by  a  tight  board  fence,  twelve  feet  high, 
with  small  iron  spikes  on  top.  Two  pavilions,  twelve  by  twenty 
feet,  were  noticed  in  one  of  the  yards,  one  having  a  rope  swing. 
Seats  were  arranged  on  two  sides.  Horse-shoes,  used  for  quoits,  were 
found  lying  on  the  ground.  On  the  north  side  of  the  yard  are  two 
privies,  with  a  tight  box  beneath.  The  soil  is  used  for  fertilizing 
purposes. 

The  women's  yard  adjoins  ihe  men's  and  measures  eighty-thrt-e  by 
fifty-four  paces.  "  It  has  quite  a  number  of  shade-trees  and  has  out-door 
conveniences.  It  is  inclosed  by  a  planed  and  pointed  close  board  fence, 
ten  feet  high.     The  grass  was  well-worn  in  both  yards. 

Heativg  and  ventilation. —  Two  furnaces  burning  hard  coal  are  in 
the  basement  of  the  old  building.  In  the  north-west  basetnent  is  an- 
other furnace.  All  are  of  the  portable  pattern.  Hot-air  pipes  are 
carried  from  them  throughout  the  building. 

Ventilation  is  effected  by  means  of  circular  openings  over  the  win- 
dows in  each  room,  which  lead  to  the  attic.  The  system,  however,  is 
imperfect,  and  the  atmosphere  at  the  time  of  visitation  was  perceptibly 

bad. 

The  new  building  has  a  large  steam  boiler  in  the  basement  and  a  ra- 
diator in  each  hall.  Ventilating  flues  are  placed  in  the  wall,  extend- 
ing through  each  floor  and  through  the  roof.  The  water-closets  are 
ventilated  in  the  same  way. 

Dining-rooms  a7idfood'—ln  the  dining-room  for  men,  tweuty-three 


Report  on  the  Oheonic  Insane.  63 

inmates  were  at  supper  at  the  time  of  visit,  seated  at  a  long  table 
covered  with  enamoled  cloth,  and  furnished  with  crockery  phites, 
bowls,  cups,  saacers,  etc.  They  were  in  charge  of  a  paid  attendant. 
Soup,  bread,  apple-sauce,  tomatoes,  boiled  rice,  sweetened  tea  and 
milk  constituted  the  evening  meal. 

The  dining-room  for  women  is  in  the  basement  of  the  new  building. 
It  is  a  pleasant  apartment  having  five  windows  provided  with  shades. 
Here  were  found  three  tables  covered  with  enameled  cloth,  and  set 
with  crockery  plates  and  cups,  steel  knives  and  forks.  Windsor 
chairs  having  bent  rails  were  used  for  seats.  The  dietary  was  given 
by  the  superintendent  as  follows:  "For  breakfast,  we  have  bread, 
meat,  potatoes,  coffee  or  tea  with  milk  and  sugar  according  to  taste; 
butter  is  allowed  twice  a  week  according  to  the  supply.  For  dinner, 
we  have  bread,  meat,  potatoes,  squash,  onions,  soup,  once  or  twice  a 
week,  and  all  kinds  of  vegetables  in  their  season,  for  we  have  plenty  of 
them.  We  use  tomatoes  quite  freely.  For  supper,  mush  and  milk, 
bread,  molasses,  cake  or  pie  twice  a  week.  We  also  have  twice  a  week 
baked  pork  and  beans,  and  on  Fridays,  codfish  for  breakfast  and  dinner. 
This  we  cook,  picked  up  and  stewed  with  milk.  We  use  beef  in  pref- 
erence to  pork.  We  serve  one  and  a  quarter  pound  daily  to  each 
inmate.  We  use  fresh  meat  almost  exclusively."  In  regard  to  the 
diet  the  physician  said :  "  I  have  examined  the  diet  for  the  insane  sev- 
eral times  and  have  approved  of  it." 

Clothing. —  The  dress  of  the  men  in  summer  was  said  to  be  "  cotton- 
ade  pants,  denim  overalls,  light  jumpers  or  frocks,  cotton  socks,  shoes 
or  boots,  and  straw  hats.  Some  go  barefooted  in  summer,  from 
choice.  In  winter,  black  felt  hats  or  caps,  cardigan  jackets,  cotton 
drawers  and  wrappers,  heavy  cotton  and  wool  socks,  and  shoes,  also 
heavy  cottonade  pants  and  boots  for  those  who  are  exposed." 

The  women  in  summer  wear  in  addition  to  the  usual  under-clothing 
**  a  calico  dress,  a  skirt,  cotton  stockings,  shoes,  and  sun-bonnet.  In 
winter  their  dress  is  similar,  with  the  addition  of  wrappers,  woolen 
stockings,  shoes  or  gaiters." 

Bedding. —  The  bedsteads  are  made  from  gas-pipe,  and  have  strap- 
iron  bottoms.  The  bedding  consists  of  a  straw  tick,  a  feather  pillow, 
two  sheets,  two  blankets  and  a  counterpane  ;  the  latter  being  removed 
at  night. 

Employment. —  The  men  are  employed  "  in  all  branches  of  farming 
and  gardening."  On  the  day  of  inspection  it  was  said  "twelve 
men  are  out  in  charge  of  an  attendant  cutting  up  corn."  This  force 
included  "  all  capable  of  working  much."  There  is  no  in-door  em- 
ployment for  the  men,  and  no  out-door  employment  for  the  women. 
The  latter  do  housework,  plain  sewing  and  repairing  of  clothes,  besides 
helping  in  the  laundry.  None  of  the  men  do  a  full  day's  work.  The 
keeper  says,  "  We  only  work  them  six  hours  a  day."  He  instructs  his 
attendants  to  restrain  them  from  doing  more.  One-fourth  of  them, 
he  said,  "could  do  a  full  day's  work  if  required;  but  three  farm 
hands  could  do  as  much  as  the  twelve."  The  keeper  gave  it  as  his 
opinion  "  that  labor  is  highly  beneficial  to  the  insane  ;  that  in  sum- 
mer they  are  not  so  nervous  as  in  winter,  and  sleep  better  at  night 
when  working  daily."  The  doctor  said,  that  in  winter  when  shut  up, 
more  complain  of  Illness  than  in  summer,  when  they  are  working 
out. 

9 


64  Report  on  the  Chronic  Insane. 

The  total  mimbcr  of  insane  September  20,  1881,  was  fifty-seven; 
twenty-four  men  and  thirty-three  women. 

Reslrabit. —  This  is  directed  by  the  keeper.  No  restraint  book  is 
kept;  patients  are  sometimes  liandcuffed  and  put  in  cells.  In  the 
attic  was  found  a  restraining  chair,  said  to  be  unused.  There  were 
also  found  two  restraining  chairs  in  the  men's  ward,  said  to  be  rarely 
used. 

In  the  new  building  was  a  muff,  and  a  i>air  of  leather  mittens  said 
to  be  out  of  use,  and  in  the  male  department,  two  pairs  of  mittens, 
and  one  muff  with  fastenings.  Tiie  kcejjer  said,  "  My  theory  is  to 
have  as  little  restraint  as  possilde,  and  to  give  them  as  much  liberty 
as  is  consistent  with  safety.  1  sometimes  refuse  them  tobacco.  When 
I  came  here  I  found  cribs  in  use  ;  I  have  never  resorted  to  them,  but 
on  the  contrary,  have  had  them  taken  apart  and  stored  in  the  attic." 
Water  t^uppli/. —  In  the  attic  there  is  a  heavy  oblong  tank,  lined 
with  galvanized  iron  for  receiving  rain  water;  it  holds  thirty  barrels. 
The  overflow  is  conveyed  to  a  cistern  in  the  basement.  A  force  pump 
also  forces  water  from  a  cistern  into  this  tank,  whence  the  build- 
ing is  supplied.  There  are  also  two  cisterns  at  the  old  building,  and 
four  at  the  poor-house,  all  of  which  are  of  sufficient  capacity.  There 
are  five  wells  on  the  ])i-emises,  one  in  front  of  the  insane  department, 
one  on  the  farm,  two  behind  the  buildings,  and  one  at  the  road  fifty 
rods  distant.  At  the  time  of  visitation  but  little  water  was  in  the 
cisterns,  and  well  water  was  being  hauled  by  teams  a  distance  of  three- 
fourths  of  a  mile.  The  keeper  said  he  had  drawn  water  nearly  all 
summer  from  the  distant  well  at  the  road.  It  is  contemplated  to 
bring  water  from  springs  one  and  three-fourth  miles  distant  toward 
the  south  and  east,  when  an  elevation  of  one  hundred  and  fifty  feet 
can  be  secured. 

Estimates  for  this  work  have  been  prepared,  and  an  appropriation 
made.  There  are  no  special  provisions  made  against  fire.  The  keeper 
said,  "  If  fire  should  break  out,  we  could  only  sit  down  and  see  it 
burn.  We  have  no  water  even  if  we  had  engines.  I  think  with  any 
kind  of  energy  we  could  get  the  inmates  out." 

Seiverage. —  The  sewer  from  the  old  building  passes  out  from  the 
men's  yard  for  a  distance  of  one  hundred  and  fifty  feet,  and  discharges 
into  an  open  ditch.  From  the  new  building  is  laid  a  ten-inch  glazed 
socket-tile  sewer,  extending  from  about  two  hundred  feet  to  a  point 
two  rods  beyond  the  women's  yard,  where  it  also  empties  into  an  open 
ditch.  The  slops  from  the  kitchen  are  emptied  into  the  sewer  outside 
the  building.  The  sewer  also  connects  with  the  laundry  and  water- 
closets  of  the  new  building.  One  of  the  wells  is  only  about  fifty  feet 
from  the  sewer.  From  these  facts  the  defects  of  the  system  will  be 
apparent. 

Paying  patients. — Patients,  residents  of  the  county,  are  received  in 
the  institution  at  13  per  week.  The  number  at  the  time  of  examina- 
tion consisted  of  nine  men  and  ten  women.  Some  derived  a  small 
income  from  personal  property,  but  not  enough  to  pay  the  regular 
price.  They  were  received,  however,  and  their  income  applied  toward 
maintenance.  There  were  no  paying  patients  from  other  counties  in 
the  institution. 

The  total  receipts  from  paying  patients  for  the  year  ending  June  30, 
1881,  were  $i,04;i.30. 


Keport  on  the  Chronic  Insane.  65 

Amuseyyients,  etc. — Papers  and  magazines  are  frequently  sent  from  the 
village  reading-room.  The  superintendent  takes  one  daily  and  two 
weekly  papers,  which  are  placed  at  the  disposal  of  the  inmates.  The 
men  play  checkers  with  the  attendants,  and  ont  of  doors  pitch  quoits. 
In  the  women's  yard  there  is  a  swing. 

General  observations. —  The  keeper  said:  "Prominent  men  of  the 
county  sometimes  visit  the  institution  to  satisfy  themselves  how  it  is 
kept,  bnt  the  majority  of  visitors  come  from  curiosity.  We  have 
sometimes  as  many  as  forty  a  day.  No  particular  day  is  set  apart  for 
visitors." 

The  examination  of  this  institution  was  made  by  Commissioner 
Letchworth  September  20,  1881.  Since  then  it  is  stated  that  the 
county  authorities  liave  directed  that  wells  be  bored  for  water,  instead 
of  seeking  a  supply  from  springs  as  above  mentioned.  Until  a  good 
supply  of  water  is  provided,  and  the  serious  defects  in  sewerage, 
already  reported  upon  by  Commissioner  Craig,  are  remedied,  it  would 
seem  proper  that  the  exemption  of  this  county  be  deferred,  and  the 
committee  so  recommend. 

Oneida  County. 

The  chronic  insane  of  Oneida  county  are  maintained  in  the  insane 
or  asylum  department  of  the  county  poor-house,  which  is  located  upon 
the  county  farm  of  two  hundred  acres,  distant  two  miles  from  the 
city  of  Rome,  with  which  it  has  telephonic  communication. 

The  poor-house  consists  of  several  brick  buildings  so  constructed 
and  joined  together  as  to  present  the  appearance  of  one  lai-ge  symmet- 
rical institution. 

The  main  two-story  center  or  administrative  building,  erected  in 
1860,  separates  the  sane  from  the  insane  department,  and  is  the  resi- 
dence of  the  county  superintendent  of  the  poor,  who  has  supervision 
of  the  institution.  In  1877  a  large  three-story  addition  was  erected 
for  the  use  of  insane  women. 

Under  the  whole  structure  is  a  basement,  of  which  the  jiart  belong- 
ing to  the  insane  department  serves  for  storage  purposes,  dining-rooms, 
a  work-room  for  the  insane  women,  and  contains  four  sleeping-rooms 
occupied  by  insane  men.  Each  of  the  rooms  is  eighteen  feet  square 
and  eight  feet  high,  with  windows  two  and  a  half  by  four  feet  above 
the  ground,  and  doors  opening  into  a  long  hall  eight  feet  wide,  there 
being  an  open  space  of  two  inches  above  and  below  each  door  for 
ventilation.  The  windows  may  be  raised  or  lowered,  and  have  spring 
fastenings. 

All  windows  throughout  tlie  insane  department  are  grated,  and 
all  above  the  basement  are  adjusted  with  weights  and  pulleys.  The 
two  strong  rooms  upon  each  floor  have  inside  gratings  to  the  large 
windows. 

The  communication  between  the  sane  and  the  insane  departments  is 
through  a  grated  door  in  the  basement  hall,  which  is  locked  except 
when  necessary  for  the  passage  of  the  car  that  conveys  the  food'pre- 
pared  in  the  kitchen  of  the  poor-house,  to  the  dining-rooms  for  the 
insane.  It  is  said  that  while  the  number  of  women  as  paupers  is  about 
half  that  of  men,  the  case  is  reversed  in  the  department  for  the  insane, 
where  the  number  of  women  is  usually  double  that  of  men.     There 


66  Report  on  the  Chronic  Insane. 

are  nine  wards  for  the  insane,  five  of  which  are  for  females.  The  four 
wards  for  men  have  forty-five  rooms,  of  which  twenty-seven  are  single 
rooms,  nine  by  five  feet  and  ten  feet  iiigii,  with  a  capacity  of  four 
hundred  and  fifty  cubic  feet.  Sixteen  are  associate  dormitories,  nine 
by  eight  feet  and  ten  feet  high,  with  u  capacity  of  three  hundred  and 
sixty  cubic  feet  of  air  per  inmate.  Each  story  is  ten  feet  high.  The 
five  wards  for  women  contain  sixty-four  rooms,  of  which  nunil)er 
tliirty-three  are  single  rooms,  fourteen  by  eighteen  feet,  with  a  capacity 
of  one  thousand  one  hundred  and  twenty  cubic  feet  of  air.  The 
twenty-eight  associate  dormitories  for  women  have  each  four  beds. 
The  dormitories  are  each  fourteen  by  seventeen,  having  a  capacity  of 
two  thousand  three  hundred  and  eighty  cubic  feet  of  air  or  five  hun- 
dred and  ninety-five  cubic  feet  of  air  per  inmate. 

Tiiere  are  no  work  or  day-rooms  for  the  insane  men  otlier  than 
their  ward  halls. 

The  basement  of  the  asylum  is  occupied  in  part  by  a  sewing  or 
work-room,  the  width  of  the  building.  This  room  is  somewhat  circu- 
lar in  form,  and  lias  seven  windows.  Opening  from  the  sewing-room 
is  a  store-room  for  materials  and  newly-made  clothing  and  bedding. 
Sixteen  of  the  })atients  are  said  to  sew  regularly,  and  do  the  sewing  for 
the  inmates  of  both  departments  of  the  institution. 

In  addition  to  the  sewing,  three  hundred  pairs  of  stockings  were 
knitted  duiing  the  past  year.  Ail  completed  articles  are  marked  with 
the  asylum  mark.  Care  is  taken  that  clothing  is  kept  exclusively  for 
the  individual  use  of  the  one  to  whom  it  is  assigned. 

Two  wards  for  insane  women  in  the  old  building  are  occupied  by 
the  aged.  The  halls  are  long  with  double  windows  at  the  end.  The 
rooms  are  carpeted  and  the  windows  curtained.  A  recess  serves  as 
a  day-room  in  each.  The  halls  have  a  comfortable,  cheerful  air,  each 
has  couches  and  chairs,  and  one  contains  a  piano.  The  old  ladies 
appeared  to  have  outlived  the  disturbed  period  of  insanity. 

The  institution  is  lighted  by  kerosene  lamps  suspended  in  the  halls. 

Each  of  the  three  female  wards  in  the  easterly  or  new  building  has 
a  day-room  corresponding  in  size,  appearance  and  exposure  to  the 
sewing-room  in  the  basement.  Strong  chairs  are  fixed  to  the  floor, 
and  where  the  insanity  of  the  patients  in  the  wards  permits,  movable 
chairs  and  couches  are  added. 

The  engine  is  in  the  basement  and  has  three  boilers,  two  of  which 
are  used  for  heating  purposes  during  the  winter,  and  the  third  or 
smaller  one  is  used  through  the  year  for  cooking,  heating  water  and 
forcing  water  to  the  top  of  the  building.  Tlie^nstitution  is  said  to 
have  been  sufficiently  warmed  by  steam,  the  ward  halls  having  heaters 
or  radiators.     No  open  fire-])]aces  are  in  use. 

Thermometers  are  supplied  in  the  wards  during  the  winter. 

The  ventilation  is  by  flues  in  tlie  walls  to  the  top  of  the  building, 
opening  into  each  room  and  hall  of  the  new  wards,  and  into  the  halls 
of  the  old  division. 

There  is  no  hospital  department. 

The  bath-rooms  in  each  ward  are  supplied  with  bath-tubs,  hot  and 
cold  water,  sinks,  towels  and  looking-glass. 

A  few  feet  soutii  of  the  building  is  a  two-story  brick  laundry  in  two 
divisions,  one  of  which  is  the  poor-house  laundry,  the  other  that  of  the 
insane. 


Report  on  the  Chronic  Insane.  67 

The  two  are  entirely  distinct  and  have  stationary  wash-tubs,  with 
steam  heat.  Soft  soap  made  from  cotton  seed  oil,  said  to  be  a  nice 
article,  is  made  and  used,  the  soap  grease  being  sold  for  about  what 
the  oil  costs.  The  drying-rooms  are  upon  the  second  floor.  The  work 
in  the  laundry  for  the  insane  is  done  by  insane  women. 

The  institution  is  supplied  with  water  from  the  Mohawk  river  by 
the  Rome  water-works.  The  water  is  said  to  be  of  good  quality  and 
i  sufficient  in  quantity.  No  means  are  taken  to  ascertain  by  measiire- 
I  ment  the  amount  delivered,  either  in  bulk  or  per  inmate.  The  pres- 
sure is  not  sufficient  to  raise  water  into  the  third  story  during  the 
early  morning,  and  hence  it  is  conveyed  into  large  cisterns,  from  which 
a  steam  pump  forces  it  over  the  building.  Later  in  the  day  power  from 
tlie  w^ater- works  raises  the  water.  Rain  water  is  conducted  by  leaders 
into  the  sewers  where  it  materially  assists  in  cleansing. 

The  sewers  are  said  to  be  properly  trapped  and  to  empty  into  ponds 
one-half  mile  distant.  Closets  open  from  each  hall  and  are  twelve  in 
number,  including, one  for  the  sewing-room  and  two  in  the  basement. 

The  two  exercise  yards  are  about  one  acre  in  extent  each,  with  a 
few  small  trees.  The  ground  is  well  covered  with  grass.  Two  small 
pavilions  with  benches  are  in  that  for  the  females,  while  a  covered 
shed  is  provided  for  the  men. 

On  September  26,  1881,  nearly  all  of  the  insane  men  were  in  their 
exercise  yard.  There  is  a  smaller  yard  of  about  one-quarter  of  an  acre 
for  the  use  of  the  women  who  work  in  the  laundry.  Outside  of  these 
yards  there  is  no  ground  appropriated  to  the  exercise  and  recreation 
of  the  insane. 

There  is  a  night-watchman. 

Upon  each  floor  hose  is  arranged  for  use,  which  can  be  connected 
with  a  powerful  steam-pump  in  case  of  fire.  Fire-escapes  are  provided 
in  each  hall.  An  attendant  occu])ies  a  room  in  each  hall.  All  cook- 
ing is  done  by  steam  in  the  kitchen  of  the  institution,  except  for  the 
sick,  whose  food  is  furnished  as  is  prescribed. 

The  basement  dining-rooms  for  both  men  and  women  are  lighted 
by  windows  and  are  distinct  from  each  other.  The  one  for  women  is 
one  hundred  and  fifteen  by  thirty-five  feet,  and  is  provided  with  chairs, 
while  tliat  for  the  men  is  thirty-five  feet  square,  and  is  provided  with 
stools.  Each  has  long  table  with  top  painted  white,  and  is  fur- 
nished with  stone- ware  plates  and  bowls,  steel  knives  and  forks,  and 
some  tin  basins  for  the  use  of  the  men. 

The  diet  is  prescribed  by  the  superintendent.  Breakfast  consists  of 
coffee,  bread  and  butter,  meat  and  potatoes.  Dinner,  Monday,  Thurs- 
day and  Saturday,  meat,  potatoes,  tea  and  bread.  Tuesday,  beans. 
Friday,  fish.  Wednesday,  soup,  potatoes  and  tea.  Sunday,  meat. 
The  vegetables  are  varied  from  day  to  day,  and  are  such  :as  are  raised 
upon  the  farm.  Meat  consists  of  pork,  beef  or  mutton.  Beef  is 
smoked  in  the  fall  and  packed  for  use.  Corn  bread  is  given  once  each 
week.  The  bread  is  daily  baked  in  brick  ovens  for  the  whole  institu- 
tion. Supper  is  of  bread  and  milk,  and  mush  with  milk  or  molasses. 
The  sick  have  food  from  the  superintendent's  kitchen,  as  is  prescribed 
by  the  physician  or  matron,  it  being  such  as  beef  tea,  mutton  broth, 
rice  and  other  suitable  articles  of  diet  for  invalids. 

The  medical  supervision  consists  of  the  daily  visits  of  Dr.  West,  who 
receives  his  appointment  from  the  superintendent  of  poor,  with  the 


68  Repobt  on  the  Cheokic  Insane. 

approval  of  the  commissioner  of  the  district.  His  annual  salary  is 
|i800,  for  which  sum  he  gives  medical  aud  surgical  attendance  to  both 
sane  and  insane,  and  provides  assistants  in  operations  and  consulta- 
tions without  additional  expense  to  the  county.  Medicines  are 
furnished  by  the  county  and  dispensed  by  Ur.  West. 

A  prescription  book  is  kept,  but  no  case  book. 

The  insane  are  registered  in  the  general  or  county  register  and  in  a 
separate  record  book  for  the  insane  department.  Certificates  of  in- 
sanity are  on  file  in  the  office. 

Citizens  of  tlie  county,  as  well  as  the  medical  profession,  prove  their 
tn'eat  interest  in  the  inmates  and  the  care  bestowed  upon  them,  by 
frequent  visitations. 

Three  male  attendants,  at  %30  per  month  each,  have  charge  of  the  in- 
sane men, with  whom  one  attendant  goes  out  daily.  Eight  female  attend- 
ants, at  13  per  week  each,  care  for  the  insane  women.  The  matron  has 
supervision  of  the  asylum,  and  has  thus  far  served  without  salary. 
Paupers  are  not  employed  in  the  care  of  the  insane.  Two  strong 
rooms  for  the  confinement  of  the  insane  are  upon  each  floor.  The 
rooms,  it  is  said,  have  not  been  used  for  three  years  previous  to  the 
last  month. 

There  are  in  the  institution  six  cribs,  four  muffs  and  two  camisoles. 
Strong  chairs  are  fastened  to  the  floor  in  wards  or  day-rooms,  aud  can 
be  used  with  simple  straps,  if  necessary,  as  restraining  chairs. 

There  are  no  iron  manacles,  fetters  or  shackles  in  use,  although 
there  are  some  belonging  to  the  institution  stored  in  the  attic.  No 
other  restraint  is  allowed.  The  attendants  administer  restraint,  and 
are  said  to  report  immediately  to  the  matron  and  superintendent. 

The  superintendent  keeps  a  restraint  book,  containing  a  record  of 
the  number  of  such  cases  aud  the  mode  of  restraint,  whether  by 
waist-belt,  wristlets,  etc.  On  the  day  of  my  visit  two  women  were  con- 
fined to  their  chairs  by  waist-belts,  and  a  girl  of  twelve  was  con- 
fined by  wristlets.     ' 

Confinement  in  dungeons  or  dark  cells  is  not  resorted  to.  Attend- 
ants, it  is  declared,  are  not  allowed  to  inflict  punishment  upon  the  in- 
sane. 

Separation  of  men  and  women  is  said  to  be  maintained  both  in  and 
out  of  the  institution. 

The  men  are  classified  according  to  their  habits,  and  the  women  by 
their  habits  and  degree  of  insanity,  this  being  arranged  by  the  matron 
and  superintendent  from  time  to  time. 

Idiots  are  retained  in  the  same  department. 

There  is  no  provision  for  epileptics,  nor  care  bestowed  upon  them  be- 
yond that  provided  for  the  insane. 

Amusements  are  not  provided  in  or  out  of  the  building  for  men  or 
women,  and  none  are  in  common  for  both.  Female  patients  are  taken 
to  walk  in  the  roads  three  times  each  week  by  attendants. 

Games  are  not  supplied.  Patients  whose  condition  permits,  attend 
services  in  the  chapel  and  through  the  week  with  two  attendants. 

The  rooms  for  the  insane  women  are  pleasant,  neat,  and  cheerful, 
but  are  neither  ornamented  nor  decorated.  The  apartments  for  the 
insane  men  are  very  inferior  in  plan,  appearance,  comfort  and  repairs, 
to  those  occupied  by  insane  women,  and  if  not  improved  others  should 
be  provided. 


Kepokt  on  the  Chronic  Insane.  69 

Flowers  are  cultivated  in  the  grounds  in  front  of  the  institution, 
and  it  is  said  are  gathered  frequently  for  the  pleasure  of  the  insane, 
who  do  not,  however,  assist  in  their  cultivation.  A  small  conservatory 
is  supplied  with  plants  by  ladies  in  Rome. 

A  visiting  committee  furnish  papers,  magazines,  and  other  reading 
matter.  Each  division  of  the  poor-house  has  a  case  of  books  that  may 
be  used  by  the  insane. 

Upon  the  farm  and  near  the  asylum  is  a  cemetery  where  the 
unclaimed  dead  are  buried  and  their  graves  marked,  a  record  being 
kept  in  the  oflBce  to  assist  friends  in  their  removal.  About  half  who 
die  are  said  to  be  claimed  by  friends.  Burial  services  are  held  at  each 
interment. 

Insane  men  are  employed  in  the  cultivation  of  the  farm  and  garden, 
under  the  supervision  of  four  farmers.  In  the  l)uilding  they  are 
emploved  at  whatever  they  can  do,  as  taking  care  of  the  wards,  paint- 
ing, etc.  The  women  have  no  out-door  employment,  but  are  engaged 
in  housework,  sewing,  aud  knitting.  About  twenty  men  can  perform 
a  fair  day's  work,  and  fifteen  a  partial  one.  The  insane  are  not  forced 
to  work.'  None  of  the  earnings  are  set  apart  for  the  insane. 

On  September  26,  the  day  of  my  visit,  two  hundred  and  seventeen 
insane  persons  were  inmates  of  the  institution,  of  whom  eighty  were 
men  and  one  hundred  and  thirty-seven  women.  Although  they  were 
very  quiet  and  orderly  for  insane  persons,  it  was  stated  that  none  could 
be  called  continuously  quiet  and  orderly. 

None  were  in  restraint  of  the  halls  or  confined  in  their  rooms.  Two 
women  and  one  man  were  in  "restraint  of  chairs."     One  man's  hands 
were  in  a  muff,  one  man  in  a  camisole,  and  two  with  hands  confined 
by  straps.     None  were  in  cribs,  dungeons,  or  cells. 
"  Ninety  of  the  whole  number  of  the  insane  have  employment. 

All  have  been  to  the  Utica  State  asylum  with  the  exception  of  about 
twenty-five,  who  were  chronic  cases  at  the  time  uf  their  admission. 

The  wooden  bedsteads  in  the  five  wards  for  women  were  new,  heavy, 
and  strong.  The  straw  beds  had  sheets  and  pillows  with  cases  upon 
them.  Comfortables  are  generally  provided.  Blankets  are  being 
introduced.     All  except  the  men's  wards  have  white  counterpanes. 

The  sewing-women  make  the  clothing  for  the  women,  as  well  as  the 
men's  shirts  and  overalls.  The  remainder  of  the  clothing  for  the  men 
is  purchased  ready-made. 

Pay-patients  are  received  at  the  rate  of  82  per  week  each,  and 
receive  the  same  care  and  treatment  as  other  patients. 

Of  the  fifty  pay-patients  in  the  institution  September  26,  seventeen 
were  resident  and  thirty-three  non-resident  of  the  county  of  Oneida; 
twenty-eight  were'  State  paupers. 

Visited  by  Commissioner  Carpenter  September  26,  1881. 

Onondaga  County. 

The  poor-house  of  the  above  county  is  located  at  Onondaga  Hill,  four 
and  a  half  miles  from  the  city  of  Syracuse. 

A  full  description  of  this  building  was  made  in  1879,  by  a  joint  com- 
mittee of  this  Board  and  the  board  of  supervisors  of  Onondaga  county. 
Acting  upon  the  report  of  this  committee,  important  changes  were 
made,  embracing  a  system  of  steam-heating  for  the  .whole  establish- 


70  Report  on  the  Cheonic  Insane. 

ment  ;  the  removal  of  the  stone  dungeons  in  the  basement ;  providing 
pleasant  sitting  and  work-rooms,  as  well  as  associate  dormitories,  in 
the  old  asylum" building  ;  also,  some  changes  in  the  system  of  sewer- 
age; the  appointment  of  a  resident  medical  superintendent;  the  sub- 
stitution of  responsible  paid  attendants  for  pauper  help;  and  the  trans- 
fer of  the  more  violent  and  disturbed  cases  to  the  Willard  asylum. 

This  committee  concur  in  the  opinion  then  expressed  by  the  joint 
committee  referred  to,  that  the  present  building  is  not  properly  de- 
signed for  the  care  of  the  chronic  insane,  and  that,  in  view  of  tlie  large 
number  to  be  provided  for  in  the  poor-house,  its  close  connection 
therewith,  the  insufficient  supply  of  water,  the  small  size  of  the  poor- 
house  farm,  the  inferior  quality  of  its  land,  etc.,  the  public  inter- 
est will  require  other  provision  for  the  chronic  insane  of  this  county. 

At  the  time  of  visitation  there  were  one  hundred  and  six  patients; 
seventy-three  males  and  thirty-three  females. 

QlJicinls  and  employes.  —  This  county  has  but  one  superintendent 
of  the  poor,  who  resides  at  Syracuse. 

The  keeper,  who  resides  in  the  poor-house,  is  appointed-  by  the  su- 
perintendent. The  joint  salary  fur  himself  and  his  wife,  who  officiates 
as  matron,  is  §800  a  year  and  living. 

In  the  insane  department  are  four  female  attendants,  whose  wages  are 
$15  per  month  each;  also,  two  male  attendants,  at  §25  per  month.  A 
baker  is  employed  in  the  poor-house  department,  at  $8  per  week.  He 
has  also  charge  of  the  general  kitchen. 

An  assistant  keeper  is  engaged  in  charge  of  the  insane  when  they 
work  out  of  doors.  There  are  also  two  *'  hired  girls"  in  the  poor-house 
department.  The  paid  force  for  the  insane  department  numbers 
thirteen  persons.     No  paupers  are  employed  on  this  staff. 

Medical  supervisio?i. —  Tiie  superintendent  appoints  the  physician, 
who  also  acts  as  superintendent  of  the  asylum  with  subordinates,  ap- 
pointed subject  to  his  approval.  His  salary  'is  §600  a  year,  and  he 
resides  at  the  poor-house. 

The  insane  are  registered  separately  at  the  office  of  the  poor-house 
department.  The  certificates  of  insanity  do  not  show  whether  the 
case  is  acute  or  chronic. 

The  consulting  physician  resides  half  a  mile  from  the  poor-house. 
Ho  visits  regularly  once  a  week,  and  oftener  if  necessary.  His  com- 
pensation is  §100  a  year.  It  was  said:  "  The  medical  profession  of  the 
county  are  not  particularly  interested  in  the  institution,  unless  to  visit 
some  patients  whom  they  have  previously  had  under  their  care." 

There  are  no  hospital-rooms  specially  provided  for  the  insane.  The 
sick  are  treated  in  tiieir  rooms.  Medicines  are  furnished  by  the  county 
and  dispensed  by  the  medical  superintendent. 

Epileptics  are  provided  with  low  beds,  elevated  but  a.  few  inches 
from  the  floor. 

Dietary. — The  following  was  given  as  the  dietary :  "  For  break- 
fast, as  a  general  thing,  potatoes  and  meat,  either  corned  beef  or 
pork,  bread  and  butter,  sweetened  coffee  with  milk.  Dinner,  pretty 
much  the  same,  except  on  Friday,  when  there  is  fish.  Cold  water  is 
served  at  dinner.  No  butter  is  supplied  except  to  the  boarders,  who 
also  have  tea  and  coffee.  Once  a  week  there  is  fresh  meat  stew ; 
sometimes  bean  soup  and  beef  soup  ;  sometimes  we  give  beets  or  onions. 
Supper  consists  of  bread  and  butter,  with  tea,  and  in  the  fruit  season 


Repoet  on  the  Chronic  Insane.  71 

sometimes  fruit.  If  we  have  no  frnit,  giiigerbrearl,  and  some  kind  of 
sauce  are  supplied.  Sometimes  we  give  green  corn  for  supper,  also 
tomatoes  and  green  peas.  Last  year  about  two  hundred  bushels  of 
apples  were  baked  in  the  poor-house  for  the  whole  establishment."  _ 

The  general  diet  is  prescribed  by  the  keeper,  and  that  for  the  sick 
by  the  medical  superintendent. 

Crockerv-ware  is  used  on  the  tables,  and  ordinary  knives,  forks  and 
spoons.  Table  cloths  are  not  used.  The  women  have  chairs  with 
backs  ;  the  men  have  stools. 

Clothing. — The  men  in  summer  are  supplied  with  shirt,  vest,  nn- 
lined  pants,  frock  or  sack  coat,  all  of  cotton  goods,  cotton  stockings, 
shoes  and  straw  hats';  in  winter,  flannel  undershirts  and  drawers, 
lined  pants,  vest  and  frock  or  sack  coat,  all  of  satinet,  woolen  stock- 
ings, shoes  and  felt  hats.  The  workers  out  of  doors  wear  boots  ;  sev- 
eral have  overcoats. 

The  women  in  summer  are  furnished  with  cotton  undergarments 
and  gingham  dresses,  also  calico  sun-bonnets.  In  winter  those  who 
workln  the  wash-house  have  canton  flannel  underwear,  quilted  skirt 
and  woolen  stockings. 

Paving  patients  generally  furnish  their  own  stockings. 

Bedding. — This  consists  of  a  tick  filled  with  straw,  two  sheets,  a 
pillow,  and  a  quilted  comfortable.  In  winter,  it  was  said,  "one  or 
more  blankets  are  added." 

Employment. —  On  the  day  of  visitation  twelve  women  were  engaged 
ironing,  six  in  the  dining-room  washing  dishes,  four  regulating  the 
sleepiug-rooms,  six  cleaning  floors  halls,  and  stairways,  and  seventeen 
were  sewing  and  knitting. 

In  the  afternoon  the  work-room  contained  about  twenty  women, 
employed  mostly  with  sewing  and  knitting,  under  the  supervision  of 
an  attendant.  The  matron  was  also  present,  part  of  the  force  assist- 
ing her  in  making  bed-quilts. 

The  apartment  was  clean  and  well  lighted,  the  walls  papered  and 
wainscoted  and  the  Avood-work  grained.  The  furniture  consisted  of 
tables,  comfortable  rocking  and  other  chairs,  while  plants  and  flowers 
added  an  air  of  cheerfulness  to  the  windows,  and  pictures  hung  npon 
the  walls. 

It  was  thought  that  ten  of  the  women  in  the  insane  department 
performed  a  fair  day's  labor.  It  was  estimated  that  one  hired  woman 
could  do  as  much  as  two  or  three  of  the  women  patients. 

On  the  same  day  five  of  the  men  were  busy  sweeping  and  house - 
cleaning;  five  were  at  work  on  the  farm. 

None  of  the  men  performed  a  fair  day's  labor,  and  but  twelve  a  par- 
tial one,  the  labor  of  three  of  the  men  being  only  equal,  it  Avas  es- 
timated, to  that  of  one  paid  laborer. 

The  influence  of  labor,  however,  upon  the  inmates  was  regarded  as 
highly  beneficial. 

Restraint. — In  answer  to  the  question  as  to  what  number  of  patients 
had  proclivities  for  escaping,  the  superintendent  said  :  "  It  is  difficult 
to  answer  that  question,  as  nearly  all  would  like  to  get  away  and  go 
home  if  they  could." 

In  the  female  department,  only  one  patient,  a  woman,  exceedingly 
profane  in  speech,  was  confined  to  her  room  at  the  time  of  visit.     The 
10 


72  Report  on  the  Chronic  Insane. 

day  being  cold  none  were  in  the  yard.  Twenty-seven  were  in  the  halls 
and  sittiiior-rooms,  or  in  their  own  rooms  with  unlocked  doors. 

In  the  men's  yard  were  two    male   patients  and  twenty  in  the  halls 
or  o])en  rooms. 
The  yards  are  in  free  communication  with  the  respective  halls. 
None  of  the   patients  were   restrained    at  the  time  of  the  visit,  in 
chairs,  cribs  or  muffs. 

Tiiere  were  on  the  premises  three  cribs  and  three  muffs  with  belts 
and  wristlets  ;  also  three  restraining  chairs,  but  one  of  which,  it  was 
said,  was  used.  Patients  are  sometimes  restrained  in  a  common  chair 
by  fastening  tliem  there.  Two  pairs  of  manacles  were  in  the  asylum, 
but  the  medical  superintendent  said,  "they  have  not  been  used  dur- 
ing my  administration,  and  I  think  they  were  not  for  some  time  pre- 
vious." 

The  matron,  who  takes  a  watchful  interest  in  the  women's  depart- 
ment, thinks  it  very  wrong  to  deceive  the  insane  under  any  circum- 
stances. She  said:  "  One  patient  brought  here  fifteen  years  ago  was  de- 
ceived by  being  told,  when  discharged  from  the  State  asylum,  that  she 
was  going  home,  and  she  has  never  forgotten  the  deceit." 

No  restraint  book  is  kept,  but  each  attendant  keeps  an  account  on 
a  slip  of  paper  and  returns  this  once  a  month  to  the  medical  superin- 
tendent. "Patients  are  sometimes  put  in  a  room  or  fastened  in  a 
chair  for  various  offenses."  Discipline  is  enforced  for  slight  misde- 
meanor by  the  attendants,  while  all  grave  cases  are  reported  to  the 
physicians.  In  the  women's  work-room  is  a  crib  made  of  black  wal- 
nut, and  all  the  wood-work  has  rounded  corners.  The  lid  is  hinged 
and  secured  by  a  covered  lock.  It  is  twenty-seven  inches  wide,  five 
feet  seven  inches  long  and  nineteen  inches  deep,and  contains  a  straw  bed, 
two  sheets,  quilt  and  counterpane. 

General  ohservations. —  During  the  last  summer  a  building  twenty- 
eight  by  seventy  feet  has  been  erected  for  a  tobacco  shed  and  work- 
shop for  repairing  tools  and  breakiniJ  stone. 

What  is  designated  as  the  old  school-house  building  has  been  en- 
larged and  repaired,  and  is  now  used  in  part  for  idiots,  also  for  shoe- 
shops  and  dormitories. 

There  is  still  some  evidence  of  dampness  in  the  upper  part  of  the 
main  building  caused  by  the  water  settling  back  under  the  slate  of 
the  roof. 

Thermometers  were  placed  in  every  ward  in  the  insane  department, 
but  no  record  of  temperature  is  kept. 

The  farm,  at  last  report,  contained  but  thirty-six  acres  of  land; 
about  sixteen  are  rough,  rocky  soil  and  devoted  to  pasture;  three  and 
a  half  acres  are  appropriated  to  the  garden  and  the  buildings;  while  the 
yards  occupy  about  two  acres  more.  The  remainder  is  cultivated  and 
in  fair  condition.  Twenty-one  acres  of  land  are  rented  by  the  county 
and  have  been  cultivated  for  corn,  beets,  oats  and  tobacco.  The  work 
is  done  by  pauper  labor.  The  farm  is  mainly  inclosed  by  stone  walls. 
Last  winter  there  was  purchased,  for  $3,000,  twenty-one  acres  adjoining 
the  leased  portion. 

The  water  sujiply  is  insufficient.  A  small  reserve  is  held  in  the 
reservoir  for  supplying  the  water-closets,  but  it  would  be  inadequate 
in  case  of  fire.  At  the  time  of  visit,  water  had  been  drawn  by  teams 
for  several  weeks. 


Keport  on  the  Chronic  Insane.  73 

A  patent  fire  extinguisher  is  in  the  insane  department.  There  are 
three  hydrants  in  different  parts  of  the  asylum  and  three  hundred  feet 
of  two-inch  hose. 

It  was  thought  that  adequate  means  of  escape  from  the  dormitories 
in  case  of  fire  was  not  provided. 

The  water-closet  for  men  is  within  the  building,  giving  rise  to  an 
offensive  odor. 

Paying  patients  receive  about  the  same  treatment  as  paupers.  They 
are  supplied  with  tea  and  coffee  and  some  extra  articles  of  food.  A 
uniform  rate  of  82  per  week  is  charged. 

The  total  receipts  from  this  source  for  the  year  ending  June  30, 
1881,  was  $1,768. 

It  is  said  that  a  number  of  papers  and  magazines  are  supplied  to 
the  asyl«m,  and  that  the  menin-doors  amuse  themselves  with  games 
of  checkers  and  cards. 

The  only  form  of  out-door  recreation  provided  for  the  women  was 
a  swing  in  their  yard. 

Religious  services  with  singing  are  held  every  alternate  Sunday,  The 
Rev.  Mr.  Huntington,  a  member  of  the  local  visiting  committee,  was 
said  to  manifest  a  special  interest  in  this  work.  It  was  further  stated 
that  "a  few  prominent  citizens  evidenced  interest  in  the  institution  by 
visiting  it,  as  do  also  the  committee  of  the  State  Board  of  Charities;  at 
the  same  time  many  persons  come  here  purely  from  curiosity." 

The  institution  was  found  clean,  and  order  prevailed  in  its  various 
departments. 

The  visitation  was  made  by  Commissioner  Letchworth  October  5, 
1881. 

Orange  County. 

The  building  for  the  insane  of  the  county  of  Orange  was  erected  in 
1875  upon  the  county  farm,  four  miles  from  the  village  of  Goshen,  and 
near  the  Orange  Farm  railroad  station  and  post-otfice.  It  is  con- 
structed of  brick  with  gray-stone  window  sills,  and  stands  at  right 
angles  with  the  poor-house,  which  it  joins,  and  of  which  it  is  a  depart- 
ment, and  communicates  with  it  by  doors  upon  the  south.  It  is  said 
to  be  fire-proof,  and  is  eighty  feet  in  length  by  forty  in  width,  having 
three  stories  and  an  attic,  with  a  basement  the  full  size  of  the  build- 
ing. There  is  no  cellar.  From  its  construction  a  fire  must  burn 
through  eight  inches  of  brick  before  communicating  with  the  story 
above  or  below. 

The  divisions  and  partition  walls  extend  from  the  foundation  to  the 
top  of  the  building,  and  consequently  the  rooms  in  the  basement  and 
the  three  stories  above,  comprising  the  four  wards,  correspond  in  size, 
number,  and  in  their  use.  A  main  hall  fourteen  feet  in  width  extends 
from  north  to  south  of  each  ward,  upon  each  side  of  which  the  rooms 
are  situated. 

The  first  ward,  or  basement,  has  nine  rooms  for  patients.  These 
rooms  upon  the  day  of  inspection  were  occupied  by  eighteen  men  of 
the  milder  forms  of  insanity.  The  east  windows  are  two  sash  and 
of  half  the  usual  size,  above  the  ground,  while  those  upon  the 
west  are  of  the  full-size,  entirely  above  ground. 

The  windows  throughout  the  second,  third  and  fourth  wards  are 


74  Report  on  the  Chronic  Insane. 

five  feet  by  two  feet  eight  inches,  double  sash,  adjusted  with  weights 
and  pulleys.  All  have  inside  gratings  on  hinges,  held  in  position  by 
a  bolt  and  brass  lock,  opening  like  a  door  when  needed  for  cleaning 
purposes.  At  the  north  of  each  ward  hall,  are  triple  windows  of  usual 
size,  arranged  to  appear  as  one. 

The  three  stories  are  each  nine  feet  high.  The  first  and  fourth 
wards  are  occupied  by  men,  and  have  eighteen  rooms  seven  by  nine 
feet,  and  one  associate  dormitory  seventeen  by  ten,  with  four  inmates. 
The  second  and  third  wards  are  occupied  by  women,  and  have 
eighteen  rooms  seven  by  nine  feet,  and  one  associate  dormitory  seven- 
teen by  ten  with  four  inmates. 

The  wards  are  heated  by  steam  from  the  same  source  as  the  poor- 
house,  and  are  said  to  have  been  sutiiciently  warm  in  the  past  winters. 
The  engines  and  boilers  are  situated  in  the  poor-house  building;  reg- 
isters are  in  each  hall  and  room. 

Upon  the  day  of  inspection  the  air  was  pure  and  the  wards  well 
ventilated.  In  the  brick  walls  are  ventilating  flues  extending  to  the 
top  of  the  building,  with  registers  in  each  room  and  hall,  each  ward 
hall  having  in  addition  four  open  fire-places.  Each  sleeping-room 
has  an  outside  window  and  a  transom  over  each  door. 

The  sick  have  no  apartments  other  than  their  ordinary  rooms. 

The  north-east  corner  room  in  each  ward  serves  as  a  bathing-room, 
and  contains  a  bath-tub,  chairs,  stationary  wash-basin,  a  glass,  and 
water  that  can  be  heated  to  any  degree  l»y  the  turning  on  of  steam. 

The  ward  halls  constitute  the  day-rooms  for  men  and  women.  The 
men  have  no  work-rooms. 

The  wash-room  or  laundry  is  in  an  extension  south  of  the  asylum, 
under  the  old  ladies'  department  of  the  poor-house,  and  is  separate 
from  that  of  the  poor-house.  It  is  furnished  with  stationary  tubs, 
hot  and  cold  water,  and  opens  into  a  drying  yard.  The  ironing  stove 
is  in  the  asylum  kitchen. 

In  the  attic  are  two  tanks  of  a  capacity  of  one  thousand  five  hun- 
dred and  twenty-seven  gallons  each,  into  which  leaders  conduct  rain 
water  from  the  roof.  The  principal  supply  of  water  comes  from  two 
springs,  the  larger  of  which  is  six  hundred  feet  distant,  and  the  other 
one  hundred  feet  soutli  of  the  closet  in  the  men's  airing  court  ;  both 
being  on  higher  ground. 

A  steam  pump  in  the  engine  and  boiler-room  of  the  poor-house 
forces  water  daily  into  and  fills  the  tanks,  from  whieh  it  is  distributed 
by  pi])es  through  the  building.  There  is  no  means  of  ascertaining 
the  quantity  of  water  used  daily  by  each  patient.  There  is  in  addi- 
tion a  well  in  the  front  yard. 

The  sewage  is  conducted  by  an  eight-inch  tile  drain  into  an  open 
ditch  five  hundred  and  fifty  feet  from  the  insane  department ;  and  is 
washed  away  by  a  stream  of  running  water.  The  ditch  drains  the 
drowned  lands  that  extend  into  !New  Jersey,  and  is  said  to  have  cost 
the  State  $G0,000.  There  is  a  closet  in  the  south-west  corner  room  of 
each  ward,  and  at  the  extreme  west  of  each  yard.  An  exercise  yard, 
one  hundred  and  forty-eight  feet  by  eighty  feet  wide,  is  provided  for 
the  use  of  insane  women  ;  while  that  for  the  men  is  one  hundred  and 
forty-eight  feet  by  forty-six  feet  wide,  having  a  shed  in  the  center, 
with  benches  underneath  ;  each  yard  is  turfed,  and  has  one  small  tree. 

The  exercise  grounds  outside  of  these  yards  consist  of  an  acre  of 


Eeport  on  the  Chronic  Insane.  75 

land  east  of  the  asylum,  upon  which  its  main  entrance  opens,  and 
contains  two  large  shade  trees  with  a  swing.  In  addition  to  the  en- 
joyment of  these  grounds,  the  insane  rove  over  the  farm  in  company 
with  their  attendants,  and  a  path  leads  to  the  wood,  where  the  women 
sit  in  the  shade. 

In  each  ward  hall  there  is  a  hose  connected  with  the  steam  pump 
in  the  engine-room,  of  sufficient  length  to  force  water  over  the  ward, 
that  is  said  to  be  at  all  times  in  readiness  for  use.  An  attendant  sleeps 
in  each  ward.  There  is  no  paid  watchman.  In  case  of  fire  the  means 
of  escape  are  the  stairs  at  the  north  of  each  hall,  doors  upon  the  south 
opening  into  the  poor-house,  and  outside  entrances. 

Much  of  the  basement  of  the  old  ladies'  department  of  the  poor- 
house  is  devoted  to  the  use  of  the  insane ;  in  it  is  the  dining  table  for 
the  insane  men  of  the  first  ward,  and  the  kitchen  where,  by  a  paid 
cook,  assisted  by  two  sane  paupers,  the  cooking  is  done  upon  a  double 
range,  and  two  steam  kettles.  The  baker  of  the  institution  makes 
bread  for  the  inmates  of  all  the  departments. 

The  diet  is  prescribed  by  the  superintendent,  from  whose  table  the 
sick  are  supplied  with  food.  A  copy  of  the  printed  dietary  will  be 
found  in  the  appendix. 

The  dining-rooms  are  in  the  south-east  part  of  each  ward.  That 
of  the  first  ward  opens  from  tlie  kitchen,  and  is  more  of  a  hall-way 
than  a  room,  having  an  uncovered  table  at  which  the  insane  men 
dine,  with  chairs,  and  a  table  service  like  that  of  the  poor-house. 

The  dining-rooms  of  the  three  remaining  wards  are  uniform  in  size 
and  -arrangement,  each  having  chairs,  a  table  covered  with  light 
enameled  cloth,  a  dumb  waiter  communicating  from  the  kitchen,  a 
sink  for  washing  dishes,  and  a  closet  with  neatly-covered  and  orna- 
mented shelves,  upon  which  are  attractively  arranged  table  service  of 
glass,  white  granite  ware,  silver  plated  knives,  forks,  spoons  and  cas- 
tors. Each  of  the  second,  third  and  fourth  ward  dining  tables  had, 
upon  the  date  of  inspection,  a  center  bouquet  of  flowers,  and  colored 
napkins,  both  for  use  and  ornament.  Each  dining-room  is  cared  for 
by  two  patients  under  the  supervision  of  an  attendant. 

There  is  no  resident  physician;  Dr.  A.  P.  Ferries  visits  the  institution, 
including  the  poor-house,  three  days  each  week,  for  which  he  receives 
an  annual  salary  of  6200.  The  medicines  are  furnished  by  the  county, 
and  dispensed  by  the  physician,  who  furnishes  his  own  surgical  instru- 
ments. In  cases  of  amputation  and  of  necessity,  different  physicians 
are  called  in  whose  bills  are  paid  by  the  superintendent.  There  is  a 
dispensary.  Surgical  operations  are  not  an  additional  charge,  unless 
they  involve  extra  visits  and  assistants. 

There  are  neither  prescription  nor  case  books  in  the  institution. 

The  poor-house  register  is  in  common  for  both  sane  and  insane.  All 
are  registered  as  paupers. 

The  certificates  of  insanity  are  on  file  in  the  institution.  Citizens 
of  the  county  visit  frequently. 

A  cook  at  $15  per  month,  and  a  laundress  at  $1  per  day,  three  or 
four  days  a  week,  are  exclusively  employed  for  the  insane. 

Each  ward  is  in  .charge  of  one  paid  attendant,  who  receives  $15 
per  month.  Paupers  do  not  assist  in  the  care  of  the  insane.  The 
superintendent  -'regulates  the  duties  and  conduct  of  the  attendants." 

There  are  no  padded  rooms,  nor  rooms  for  the  confinement  or  isola- 


76  Report  on  the  Chronic  Insane. 

tion  of  the  insane,  other  than  their  sleeping-rooms.  Two  of  the  six 
cribs  are  said  to  be  used  with  open  lids,  because  of  the  need  of  beds; 
the  third  is  required  and  occupied  regularly  at  night. 

The  county  has  provided  one  restraining-chair  with  straps,  six 
muffs,  six  camisoles,  one  pair  of  iron  shackles,  said  to  have  been  used 
once  for  two  hours  within  the  past  year;  one  pair  iron  handcuffs, 
tw^elve  leather  straps,  and  six  pairs  leather  wristlets.  There  are  no 
other  means  of  restraint  in  use  in  the  institution.  It  was  stated,  "  that  if 
too  noisy,  destructive,  violent,  pugilistic  or  quarrelsome,  the  lunatic  is 
put  in  his  room  or  chair  till  he  cools  down,"  and  that  restraint  is  be- 
coming less  used  or  necessary.  It  is  regulated  by  the  attendants  upon 
each  ward,  wlio  do  not  keep  restraint  books. 

The  sui)erintendent  states  that  he  does  not  allow  the  insane  to  be 
punished,  and  there  are  no  dungeons  nor  dark  cells  for  their  confine- 
ment. 

The  insane  are  classified  by  the  superintendent  according  to  their  de- 
gree of  insanity. 

Epileptics  have  no  separate  care,  but  are  said  to  be  more  closely 
watched  than  other  inmates.     There  is  no  night-watchman. 

The  men  and  women  have  separate  dining-rooms,  wards,  yards, 
and  exercise-grounds,  and  do  not  see  each  other,  except  that  all  attend 
Sabbath  services,  and  are  seated  in  difftn-ent  portions  of  the  second 
ward  hall,  into  which  the  organ  is  brought  for  the  occasion.  At  other 
times  the  organ  is  in  the  reception  or  entrance-hall.  The  organ  was 
purchased  in  1880,  at  a  cost  of  $70,  of  which  sum  $20 
is  said  to  have  been  subscribed  in  the  institution,  the  remain- 
der by  Goshen  churches ;  at  the  same  time  16,  the  amount 
contributed  above  the  cost  of  the  organ,  was  expended  for  singing- 
books. 

Religious  services  are  held  in  the  ward-hall  by  different  ministers 
from  the  county,  who  receive  a  compensation  of  $2,   each  Sabbath. 

The  reception-room  is  seventeen  by  ten  feet,  and  contains  a  black- 
walnut  bookcase  made  by  a  former  inmate.  It  is  six  by  seven  feet  in 
size,  is  neatly  carved,  and  has  six  shelves,  with  a  few  books  upon  them, 
'J'he  room  is  also  furnished  with  comfortable  chairs  and  a  sofa. 

The  idiotic  adults  are  not  classed  with  the  insane,  but  are  given  a 
place  in  the  department  for  the  sane.  There  are  no  feeble-minded  nor 
idiotic  children  among  the  insane. 

The  men  exercise  in  the  open  air,  and  have  a  swing.  In-doors  they 
have  cards,  dominoes  and  other  games.  The  women  exercise  in  the 
open  air,  and  have  a  hammock  and  swings.  In-doors,  games  are  pro- 
vided, but  it  is  said  that  the  majority  do  not  care  for  them.  There  is 
at  times  dancing,  music,  and  reading  aloud  by  the  attendants.  Neither 
out  nor  in-door  amusements  are  in  common  to  all. 

The  county  supplies  the  county  papers,  and  each  editor  donates  a 
copy  to  the  insane. 

The  wards  for  the  women  are  prettily  ornamented  with  autumn 
leaves,  wreaths,  engravings,  and  window  draperies,  tastefully  arranged 
by  the  attendants.  The  piano  in  the  third  ward,  as  well  as  many 
pieces  of  ornament  and  furniture,  is  said  to  be  the  property  of  the  at- 
tendant. 

All  the  wards  are  furnislied  with  chairs,  sofas,  tables,  etc.  There  is 
cool  drinking-water  in  each   ward  hall.     The   wards  are  lighted  by 


Report  on  the  Chronic  Insane.  77 

kerosene  lamps.  The  associate  dormitories  are  very  neatly  furnished. 
All  the  Avindows  have  green  shades.  The  third  ward  is  provided  with 
mosquito  nets. 

The  insane  at  times  assist  in  the  care  of  a  flower-garden,  forty  feet 
square,  overlooked  by  the  hall  windows.  The  men  are  employed  upon 
the  farm,  but  labor  principally  in  the  garden,  and  liave  no  in-door  oc- 
cupation. The  women  assist  in  the  house-work,  and  have  no  out- 
door employment. 

About  half  of  the  men  and  women  can  work  a  portion  of  the  time, 
but  none  are  to  be  relied  upon  from  day  to  day,  and  no  attempt  is 
made  to  furnish  continuous  work. 

Labor  is  performed  under  the  immediate  supervision  of  attendants, 
by  direction  of  the  superintendent  and  matron. 

Wliile  labor  is  considered  one  of  the  greatest  benefits  to  the  insane, 
it  is  valuable  also  in  so  far  as  it  does  away  with  hired  laborers. 

Twelve  of  the  insane  are  generally  in  the  sane  department  of  the 
poor-house.  All,  with  one  exception,  work,  unless  prevented  by 
paroxysms,  when  they  are  removed  to  the  asylum. 

The  number  of  the  insane  September  first,  the  day  of  inspection, 
was  eighty-five ;  males,  forty-three ;  females,  forty-two.  Of  the 
whole  number,  all  were  said  to  be  quiet  and  orderly,  except  "by 
spells." 

Four  men  and  one  woman  were  in  restraint  of  the  halls,  one  man  in 
restraint  of  a  chair,  two  men  in  muffs,  and  it  is  said  that  it  has  been 
necessary  to  confine  the  hands  of  one  woman  in  a  muff  nine  months  of 
the  year.     One  woman  sleeps  in  a  crib. 

But  one  inmate  of  the  third  ward  can  be  trusted  without  an  attend- 
ant. All  who  have  been  received  during  the  past  twelve  years  have 
been  treated  in  State  asylums.  About  twelve  insane  were  inmates  of 
the  poor  house  previous  to  that  time,  concerning  whom  little  is  known 
by  the  present  officials. 

'  There  is  no  separate  hospital  department.  The  bedsteads  through- 
out the  institution  are  of  iron,  and  except  in  the  associate  dormitories 
are  of  large  size,  and  are  occupied  by  one  or  two  persons  according 
to  the  number  in  the  institution  and  the  character  and  degree  of  in- 
sanity. The  straw  beds  are  boxed  to  appear  like  mattresses,  and  the 
straw  changed  quarterly,  unless  required  more  frequently.  Each  bed 
Has  one  pair  of  sheets,  husk  bolster  and  feather  pillows.  The  beds 
were  all  clean  and  neatly  made  and  each  was  provided  with  a  com- 
fortable or  rose  blanket  and  white  counterpane. 

The  walls  are  whitewashed  once  in  six  weeks.  Tar  is  burned  to 
purify  the  air.  The  halls,  rooms  and  furniture  are  said  to  be  washed 
each  week  with  a  solution  of  carbolic  acid. 

Ready-made  clothing  for  the  men  is  purchased  in  New  York,  except 
shirts  and  overalls  which  are  made  in  the  house.  The  clothing  for  the 
women  is  made  by  both  the  sane  and  the  insane  women  in  the  insti- 
tution.    Flannel  is  furnished  if  it  is  needed  throughout  the  year. 

The  acute  insane  do  not  remain  in  the  institution,  but  are  removed 
by  the  superintendent  to  State  asylums. 

Pay  patients  would  be  received  if  there  were  room.  A  special  law 
permits  the  reception  of  patients  from  Orange,  Rockland  and  Ulster 
counties.  Upon  September  1,  one  pay  patient  was  resident  at  15  per 
week,  who  received  the  same  care  as  the  public  patients. 


78  Report  on  the  Chronic  Insane. 

Omnge  county  has  thirty-seven  insane  at  Middletown,  of  whom 
twenty  are  considered  chronic  cases  ;  but  the  present  limited  accom- 
modations for  the  insane  u])on  Orange  Farm  do  not  permit  their  re- 
turn to  county  care. 

Visited  by  Commissioner  Carpenter,  September  1,  1881. 

Oswego  Cocnty. 

The  poor-house  of  this  county  is  situated  on  a  slight  elevation, 
eighty  feet  from  the  highway,  distant  about  a  mile  and  a  half  from 
the  village  of  Mexico,  its  post-office  and  railroad  station. 

The  ground  in  front  is  planted  with  trees  and  flowers,  and  inclosed 
by  a  neat  fence.  The  building,  two  brick  stories  above  a  stone  bivse- 
nlent,  consists  of  a  central  section  surmounted  by  a  tower,  and  two 
L-shaped  wings. 

The  central  section  has  a  tin  roof.  On  the  main  floor  of  this  division 
are  a  parlor  and  office,  with  sleeping  apartments  above.  This  portion 
of  the  building  is  occupied  by  the  keeper  of  the  insane  department, 
and  the  right  wing  is  used  for  the  insane.  The  left  wing  is  occupied 
by  the  officials  and  inmates  of  the  poor-house  proper;  the  general 
office  of  the  institution  being  also  here. 

Officials  and  employes. —  This  county  has  but  one  superintendent 
of  the  poor,  who  resides  in  the  jioor-house.  His  compensation  is  $2 
per  day,  with  living  for  family.  His  wife  acts  as  matron  of  the  poor- 
house  department  at  a  remuneration  of  $4  per  week. 

The  poor-house  is  in  charge  of  a  keeper,  who  also  lives  in  the 
poor-house,  and  is  paid  for  the  services  of  himself  and  wife  $450  per 
year  and  living.  A  female  assistant  receives  $2  per  week  ;  and  a  man 
is  employed  for  farm  work  at  $30  per  month.  The  latter  has  charge 
of  the  insane  when  employed  out  of  doors. 

The  insane  department  is  in  charge  of  a  keeper,  who  with  his  wife 
and  daughter  reside  in  the  building.  He  is  paid  for  himself  and  wife 
$400  a  year  and  living.  The  daughter  acts  as  an  assistant,  and  re- 
ceives ^'l  per  week. 

All  subordinate  officers  are  appointed  by  the  superintendent.  There 
are  no  paid  attendants  in  the  insane  department.  The  keeper  says, 
"  We  do  our  own  work  with  the  help  of  the  insane,  including  wash- 
ing; besides  helping  on  the  poor-house  farm." 

Medical, supervision. —  The  county  physician  resides  at  Mexico. 
He  is  required  to  visit  the  institution  daily.  His  compensation  is  $1 
per  day  ;  receiving  no  pay  for  extra  services. 

Medicines  are  supplied  by  the  county,  and  are  dispensed,  it  was 
said,  by  the  keeper  according  to  instructions  from  the  physician.  The 
latter  informed  the  Commissioner  that  the  consulting  physician 
generally  visited  the  institution  with  him  once  a  month,  adding  that 
there  was  not  mucii  interest  evinced  by  a  majority  of  the  physicians  in 
the  county  ;  but  three  or  four  visited  it  occasionally. 

General  description. —  Some  little  delay  occurred  in  beginning  the 
inspection  of  the  institution,  from  the  fact  that  on  the  arrival  of  the 
Commissioner,  the  keeper  was  absent  in  the  flelds,  and  had  the  keys 
with  him. 

As  there  were  no  attendants  in  the  asylum,  access  to  the  wards  of 
the  insane  department  could  not  be  had  until  his  return.     His  wife 


Keport  on  the  Chronic  Insane.  79 

also  being  absent  on  account  of  the  death  of  a  relative,  no  one  was  in 
charge,  but  the  daughter,  a  young  miss  of  eighteen  years. 

The  building  or  wing  for  "the  insane  is  a  rambling  structure,  the 
interior  having  irregular  halls  and  rooms,  and  some  crooked  stairways. 
The  windows  having  outside  iron  gratings,  each  contain  twenty-four 
panes  of  glass,  six  by  nine  inches. 

One  of  the  rooms  on  the.first  floor,  nineteen  by  twenty-two  feet,  and 
eleven  feet  high,  is  used  as  a  sitting-room  ;  the  floor  is  painted,  and 
the  windows  provided  with  muslin  curtains.  The  furniture  consisted 
of  arm  chair,  stationary  wall-benches,  a  round  table  and  a  looking 
glass.     1'he  walls  were  bare. 

In  consequence  of  the  over-crowded  condition  of  the  asylum,  two 
beds  were  placed  on  each  side  of  this  room.  Three  patients  were 
quietlv  sitting  here  at  the  time  of  inspection. 

In  rear  of  this  room,  and  separated  from  it  by  upright  hard- 
wood studding,  placed  three  inches  apart,  is  a  range  of  cells  each  five 
by  seven  feet,  and  eleven  feet  high.  In  the  studding  was  an  opening, 
five  by  nine  inches,  through  which  food  might  be  passed.  The  cells 
have  hard- wood  doors,  secured  by  two  heavy  bar-latches  at  the  top  and 
bottom.  The  keeper  said,  "The  doors  are  left  open  at  night,  unless  the 
patients  choose  to  close  them."  The  furniture  comprised  bedstead,  bed- 
ding, and  night  conveniences.  Nails  were  /Iriven  in  the  wall  on  one 
side' for  hanging  clothes.  In  each  cell  is  a  window  containing  four 
panes  of  glass,  each  six  by  nine  inches. 

Adjoining  the  sitting-room  is  a  good-sized  apartment,  used  as  a 
hospital  for  women.  It  contained  a  patient  eighty-six  years  old, 
who  had  been  an  inmate  about  eighteen  years. 

The  bedsteads  in  use  were  of  the  French  pattern  and  there  was  a 
comfortable  supply  of  bedding.  A  flower-stand  filled  with  boxes  of 
plants  was  in  one  corner.  The  painted  floor  was  clean,  and  the  room 
orderly.  Adjoining  the  hospital  is  a  ward  with  cells  for  women  cor- 
responding to  the  male  ward  on  the  same  floor.  It  was  furnished  with 
Four  flag-bottomed  chairs,  three  rockers,  an  arm-chair  on  rollers,  a 
table  wFth  enameled  cloth  cover,  on  which  were  a  few  newspapers,  a 
small  stand,  a  sewing-machine,  green  paper  shades,  a  small  looking 
^lass,  a  few  wall  ornaments  and  a  kerosene  bracket-lamp.  Here  were 
five  inmates;  two  were  reading,  one  knitting,  two  were  sitting  list- 
lessly, another  was  somewhat^excited.  All  were  cleanly  dressed  and 
hair  tidily  arranged. 

Opening  into  this  ward  is  a  cell  termed  "  the  dark  hall."  Here  was 
a  restraining-chair  said  to  be  used  only  as  a   commode  for  a   cripple. 

Here  likewise  from  overcrowding  was  a  bed.  Opening  into  this 
room  is  a  long,  dark  clothes-press. 

The  women's  ward  for  disturbed  cases,  in  the  rear  building,  com- 
prises a  central  hall,  lighted  by  two  windows  at  the  farther  end,  and 
twelve  cells,  seven  on  one  side  and  five  on  the  other.  One  is  used  as  a 
oath-room  and  is  supplied  with  hot  and  cold  water.  Patients  are  re- 
][uired  to  bathe  once  a  week,  the  filthy  cases  oftener. 

The  cells  here  correspond  with  those  already  described.  The  hall 
svas  furnished  with  eight  strong  but  comfortable  chairs,  recommended 
by  the  comm.issioner  of  the  district.     These  were   arranged  along  the 

de  of  the  hall  and  were  secured  to  the  flooi-. 

Fourteen   patients   were   here   at  the  time  of  visit ;   one  afflicted 
11 


31 


80  Rkpokt  ox  tuk  Chkonic  Insane. 

with  canctT  occupiea  one  of  ilie  cells,  the  door  of  which  was  unlocked  ; 
another  hiid  goitre  ;  ii  third  was  restrained  by  wristlet  and  waist- 
6tra|)8.  The  keeper  said,  "She  is  sometimes  seized  with  an  impulse 
to  strike,  aiid  at  one  time  injured  mv  wife  by  hittinj:  lier  in  the 
mouth.  One  of  the  patients  in  the  asvhim  had  formerly  wore  straps 
for  several  vears.  "  I  tc.ok  the  responsibility  of  removing  them  when 
I  came,  four  years  ago,  and  have  not  put  them  on  since,  except  in  a 
few  instances,  and  then  they  were  worn  but  a  few  hours  at  a  time. 
Tliree  of  the  women  were  barefooted,  and  about  one-half  had  their 
hair  shortened,  "some,"  according  to  the  statement  of  the  keeper, 
"  from  choice."  One  of  the  patients  here  was  understood  to  have 
charge  of  the  restt.     All  were  ouiet. 

Tlie   cells    were  furnished  with  beds  only.     The  walls  were  without 

ornament.  .        ,    jj  j      n 

A  similar  ward  for  men  was  on  the  floor  below,  having  studded  cells 
or  rooms  on  the  sides.  One  of  these  contained  four  beds.  It  was 
large,  four  cells  having,  by  the  removal  of  ])artitions,  been  connected 
into  one.  In  the  ward  were  seven  strong,  comfortable  chairs,  like  those 
in  the  women's  ward  ;  two  wooden  settees,  one  with  three,  the  other 
with  six  seats.  Three  men  were  quietly  sitting  in  this  hall,  the  un- 
fastened door  of  which  communicated  with  the  yard. 

On  the  thinl  floor  are  live  associate  dormitories,  three  having  four 
beds  each,  one  six,  and  one  three  beds.  There  are  also  two  single 
rooms,  each  containing  a  bed,  in  all,  twenty-three  beds.  A  daugh- 
ter of  the  keeper,  a  girl  eighteen  years  of  age,  sleeps  in  a  room 
on  this  floor.  The  ceiling  of  this  floor  is  twelve  feet  high,  the  floor 
painted,  and  some  of  the  walls  papered.  The  beds  were  well  made 
and  the  rooms  cleanly  kept.  The  dormitories  on  this  floor  are  used 
only  at  night,  unless  "  at  times  in  a  few  exceptional  cases." 

Stairwa'\-s  extend  through  each  end  of  the  main  wing,  and  in  tlie 
rear  projection,  at  its  junction  with  the  building. 

In  the  WHsh-room,  which  is  located  in  the  basement  near  the  dining- 
rooms,  six  women  were  engaged  in  washing,  round  tubs  being  in 
general  use.  The  room  was  supplied  with  hot  and  cold  water  ;  had  a 
small  cauldron  for  boiling  clothes,  and  other  requisite  appliances.  A 
male  patient  was  using  a  patent  wringer  for  wringing  clothes.  One 
of  the  women  likewise  had  charge  of  this  work,  and  was  very  active. 
The  keeper  said,  that  at  times  it  was  necessary  to  restrict  her  to  pre- 
vent overwork.  It  was  necessary  to  watch  another  patient  in  this 
respect. 

Yards. —  The  men's  yard  is  inclosed  by  a  tight  board  fence,  planed 
and  painted,  twelve  feet  in  height.  In  the  short  turf  were  numerous 
paths  well  worn.  On  one  side  was  a  pavilion  six  by  twenty-four  feet, 
in  which  were  sitting  two  patients  just  in  from  work  on  the  farm, 
and  awaiting  dinner.  There  were  no  shade  trees  ;  the  water-closet 
was  constructed  with  a  box  underneath  for  the  utilization  of  night 
soil.     The  keeper  of  the  poor-house  said  :  '*  These  as  well  as  all  others 


are  cleaned  every  two  weeks,  and  supplied  with  dry  muck  every  three 
or  four  days." 

In  the  yard  were  eight  men,  all  of  whom  were  quiet.  One  was  a 
lawver,  and  a  former  graduate   of  Hamilton  College. 

The  women's  yard  adjoins  that  of  the  men,  is  fifty  by  one  hundred 
feet,  of  similar  description,  has  pavilion  of  the  same  size,  and  water-. 


Report  on  the  Chronic  Insane,  81 

closet.  This  yard  is  shaded  by  a  few  apple  trees.  Throe  or  four 
patients  were  here  engaged  in  hanging  clothes  upon  a  line.  Under  the 
pavilion  was  a  discarded  crib  without  a  lid. 

Heating  and  ventilation. —  The  insane  department  is  heated  by  a 
tubular  steam  boiler,  three  by  seven  feet,  located  in  the  basement; 
pipes  lead  to  radiators  placed  in  various  parts  of  the  building.  The 
smoke-stack  is  carried  ujjward  through  a  large  wooden  Hue,  designed 
to  exhaust  the  foul  air  by  flues  therefrom,  connecting  with  the  several 
rooms. 

The  physician  thought  the  ventilation  was  not  entirely  effectual. 
Thermometers  are  hung  in  the  wards,  halls  and  sitting-rooms,  but 
no  daily  record  is  made  of  the  temperature.  The  keeper  said,  "  In 
cold  weather  we  run  as  near  sixty-tive  degrees  as  we  can." 

Food. —  In  the  men  and  women's  dining-rooms  and  kitchen  were 
five  women  patients  engaged  in  cooking  and  preparing  the  table  for 
dinner  ;  one  having  sjiecial  charge  of  tlie  dining-room,  another  the 
kitchen.  Uncovered  deal  tables,  white  crockery  plates,  bowls,  tea- 
cups and  saucers,  steel  knives  and  forks,  tinned  iron  spoons,  glass  salt 
cellars  and  tin  pepper  boxes  were  in  use.  Round  top  stools  were 
placed  for  eighteen  inmates.  In  the  women's  dining-room  was  a  cup- 
board for  dishes,  and  two  clothes-racks  hung  witli  clothes.  The  table 
was  set  for  thirty-two  women.  Food  was  carried  to  the  remaining 
patients  in  the  ward,  except  to  two  paying  patients.  Later  the  patients 
were  seen  at  dinner,  to  which  they  were  summoned  by  an  ordinary 
dinner  bell,  rung  by  the  keeper,  in  a  way  that  betokened  somewhat 
of  family  life.  The  keeper,  assisted  by  his  daughter,  was  present  and 
served  the  food.  The  dinner  consisted  of  a  piece  of  boiled  pork, 
which  the  keeper  said  was  their  "'  staple  meat,"  placed  on  each  plate, 
a  piece  of  butter,  and  unpeeled  boiled  potatoes,  milk,  and  gravy;  also 
unsweetened  tea  with  milk. 

The  keeper  gave  the  regular  dietary  as  follows:  "For  breakfast, 
unsweetened  coffee  with  milk,  hop-yeast  bread,  and  pickled  codfish, 
cooked  in  milk,  or  boiled  pork  or  beef.  For  dinner,  beef  or  pork,  and 
occasionally  fresh  fish,  the  pork  being  boiled  and  the  beef  in  the  form 
of  a  stew,  pickled  beets,  lettuce,  and  such  food  as  make  up  a  farmer's 
diet  ;  sometimes  tomatoes  or  boiled  cabbage  are  supplied.  Supper  is 
a  light  meal,  and  consists  of  bread  or  mush  and  milk.  This  is  pretty 
nearly  the  average  diet;  we  cannot  confine  ourselves  to  any  particular 
thing ;  we  have  more  beef  in  winter  than  in  summer." 

Clothing. —  The  dress  of  the  inmates  was  stated  to  be  as  follows : 
"  In  summer  the  men  wear  a  white  or  colored  shirt,  cottonade  pants, 
or  similar  goods,  vest  and  frock  coat.  In  extremely  hot  weather  some 
have  linen  coats.  Cotton  socks  are  worn  by  the  men  the  year  round, 
except  those  who  work  out  of  doors.  Some  of  these  wear  woolen 
socks,  some  wear  slippers,  and  some  boots  or  shoes.  In  winter  some 
wear  cotton  and  others  woolen  shirts.  All  who  will  wear  them  are 
supplied  with  knitted  woolen  drawers  and  shirts.  Pants  are  lined 
and  furnished  of  cotton  and  woolen  mixed  goods.  The  vest  and  coat 
are  of  the  same  material,  while  the  cost  is  from  *8  to  $10  per  suit. 
Two  or  three  who  assist  in  doing  chores  in  winter  have  overcoats." 

"  The  dress  of  the  women  in  summer  consists  generally  of  a  cotton 
chemise,  a  few  of  the  feebler  wearing  canton  flannel  under-clothing, 
cotton  skirt  and  gingham  dress,  cotton  stockings,  and  shoes  or  slip- 


82  Report  on  the  Chronic  Insane. 

pers.  Those  who  want  them  hiive  gingliam  sun-bonnets.  Two  are 
always  kept  hanging  at  the  door  at  the  exit  to  the  yard,  and  some 
have  their  own.  A  great  many  will  not  wear  them.  In  the  winter 
woolen  stockings  are  furnished;  a  good  many  have  quilted  skirts  and 
under-waist.     The  dresses  are  of  various  colors." 

BediliiKj. —  The  bedsteads  mostly  used  are  of  the  "Willard  asylum 
pattern,  with  hoop  iron  bottom.  The  bedding,  with  a  few  exceptions, 
consists  of  two  straw  ticks,  generally  a  straw  pillow,  two  sheets,  a 
tufted  comfortable  and  white  counterpane,  removed  at  night.  It  was 
said ''two  or  mure  comfortables  are  used, in  cold  weather.  A  few  of 
the  beds  had  feather  pillows,  furnished  by  friends." 

Emi>l(njment. —  The  total  number  of  the  insane  here  is  fifty-six,  of 
whom  eighteen  are  men  and  thirty-eight  are  women. 

Aside  from  the  work  done  by  the  women  in  the  laundry,  kitchen, 
dining-room  and  dormitories,  the  insane  assist  in  making  the  clothing 
and  bedding  for  the  inmates.  The  keeper  stated  that  "all  the  pa- 
tients'dresses  and  underwear  were  made  by  his  wife,  assisted  by  the 
women  ;  and  all  the  men's  shirts,  as  also  the  bedding  for  the  whole 
establishment." 

The  men  who  work  out  of  doors  do  most  kinds  of  farm  labor,  tak- 
ing care  of  the  stock,  milking,  mowing,  cradling  and  hoeing,  but  none 
are  allowed  to  drive  a  team.  In  winter  the  men  must  remain  abso- 
lutely idle,  as  no  in-door  employment  can  be  furnished.  One  of  the 
men  brings  in  the  wood  and  coal  and  helps  in  the  laundry. 

Only  one  of  the  men  performs  a  fair  day's  labor  and  two  a  partial 
day's  work.  Of  the  women,  five  perform  a  fair  day's  labor  and  seven 
a  partial  day's  work.  The  keeper  thinks  that  the  whole  labor  of  all 
the  men  is  equal  to  that  of  two  hired  men  and  of  the  woiuen  to  tliat  of 
four  hired  servants,  except  that  on  washing  days,  it  would  require  six 
to  perform  the  same  amount  of  work.  The  keeper  said  "  the  more  the 
men  labor  the  better  it  is  for  them,  unless  they  are  overworked." 

It  was  stated  that  "one  of  the  insane  in  each  department  had  charge 
over  the  rest  about  them."  One  of  the  men  the  keeper  styled  his 
deputy.  The  keeper  said  "he  thought  he  got  along  better  than  if  he 
had  more  paid  attendants." 

Restraint. — At  the  time  of  visit  none  were  restrained  in  their 
rooms  or  cells.  The  halls,  dining-rooms  and  kitchen,  the  hospital- 
room,  laundry-room  and  yard  were  in  free  communication,  except  as 
to  the  separation  of  the  sexes.  All  of  the  inmates  were  in  the  build- 
ing or  yards,  except  five  who  were  at  work  on  the  farm,  under  charge 
of  the  "  hired  man."  None  were  in  mechanical  restraint,  except  the 
one  already  mentioned.  There  are  no  restraining  chairs  in  the  insti- 
tution, nor  camisoles;  there  is  one  muflF,  two  pairs  of  hand-cuffs  and 
one  pair  of  shackles.  The  keeper  said,  "I have  used  these  very  sel- 
dom, and  have  never  used  but  a  single  pair  at  any  one  time  ;  have 
never  used  them  in  taking  patients  to  Utica,  although  some  were  ex- 
tremely violent.  I  sometimes  order  patients  to  remain  a  few  minutes. 
In  this  I  am  governed  by  circumstances;  punishment  is  never  in- 
flicted; excited  patients  are  secluded  in  their  rooms  until  the  spasm 
is  over.     I  never  show  temper  or  anger  under  any  circumstances." 

In  the  baseiuent  is  a  room  thirteen  feet  long  by  twelve  feet  wide 
with  seven  and  a  half  feet  coiling,  in  which  two  cells,  six  by  six  and  a 
half  feet,  are  set  off  by  upright  studding.     This  is  used  for  refractory 


Eepoiit  on  the  Chronic  Insane.  83 

cases.  One  of  the  doors  has  two  heavy  bars  extending  from  top  to 
bottom  with  a  strong,  heavy  bar  and  staple  across  the  center.  This 
room  has  two  outside  windows.  In  one  of  the  cells  was  a  board  at  the 
height  of  a  bed,  with  straw  tick,  straw  pillow  and  blankets.  In  the 
other  was  a  bunk,  with  straw  tick  and  other  bedding.  Secured  to  the 
wall  was  a  sliort  chain,  about  one  foot  long,  with  ring  attached.  The 
cells  were  warmed  by  steam  pipes. 

Wafer  siqjpli/. — Water  is  supplied  from  a  spring  half  a  mile  distant ; 
a  windmill  forces  it  into  two  reservoirs,  one  hundred  and  twenty-five 
feet  above  the  spring,  from  whence  it  is  distributed  by  gravitation. 
These  reservoirs  contain  sixty  barrels  each;  the/pipe  from  the  spring 
is  one  and  one-half  inch  ;  there  are  six  faucets  in  the  insane  depart- 
ment, to  which  in  case  of  tire,  three-fourths-inch  rubber  hose  may  be 
attached,  of  which  there  is  about  one  hundred  feet.  The  bnildiugs  are 
insured.  The  water  supply  was  brought  into  use  in  August  last ; 
previous  to  which  water  was  drawn  by  teams. 

tSeweroge.  —  A  tile  drain  extends  under  and  into  the  asylum  build- 
ing to  the  laundry;  this  also  receives  the  discharge  of  two  water- 
closets  within  the  building.  A  four-inch  drain  tile  extends  outward 
from  the  furnace-room  to  carry  off  surface  water;  which  in  the  spring- 
time had  caused  serious  inconvenience.  This  drain  also  receives  the 
slo))s  outside  the  building.  Another  drain,  near  the  kitchen  door,  dis- 
charges into  one  of  the  main  drains.  The  surplus  water  from  the 
reservoir  discliarges  into  the  sewer  system.  The  first  named  sewer 
empties  into  a  ditch,  six  or  eight  rods  distant  from  the  building. 
Other  sewers  discharge  at  the  same  distance  from  the  building,  on  a 
flat  piece  of  ground.  The  keeper  of  the  poor-house  said,  "  Great 
pains  are  taken  to  purify  the  open  sewer."  The  water-closets  in  the 
wards  are  not  self-flushing,  and  one  of  them  was  quite  offensive  for 
this  reason. 

General  ohservatmis. —  The  farm  connected  with  the  house  is  small, 
comprising  only  seventy-five  acres.  There  are  a  few  old  apple  trees  of 
but  little  account.  A  small  orchard,  containing  fifty  trees  of  grafted 
fruit,  was  planted  a  year  ago.  Eight  cows  are  kept,  the  milk  from 
which  is  principally  used  by  the  inmates.  It  was  said,  that  "  a  ton  of 
butter  was  made  and  used  in  the  house."  About  two  and  a  half  acres 
are  approjjriated  to  a  vegetable  garden,  principally  planted  with  beets 
and  cabbage  for  winter  use.  Here  also  are  raised  a  variety  of  garden 
products,  including  sweet  corn,  peas,  beans,  carrots,  tomatoes,  cucum- 
bers, etc. 

Paying  patients  are  received  at  the  uniform  rate  of  §2  per  week. 
There  are  only  three  at  present,  two  women  and  one  man  ;  these  are 
quiet  cases;  two  of  these  eat  at  the  keeper's  table,  and  receive  extra 
care  and  attention  to  their  clothing. 

The  amount  received  during  the  fiscal  year  from  paying  patients 
was  14(31-30. 

Abundant  reading  matter  is  supplied  by  people  of  the  county,  part 
of  this  literature  finding  its  way  into  the  insane  department.  Means 
of  playing  checkers,  backgammon  and  dominoes  are  furnished  to  the 
men. 

No  special  provision  is  made  for  epileptics. 

The  idiotic  class,  of  which  there  are  but  few,  are  cared  for  in  award 
in  the  pauper  department  which,  with  the  remaining  establishment. 


84  Report  on  the  Chronic  Insane. 

was  also  visited.  One  of  the  idiots  here  is  a  girl  nine  years  old,  unable 
to  talk  or  feed  herself,  destructive  of  clothing,  and  a  source  of  much 
trouble.  She  was  in  charge  of  a  pauper  woman.  Her  hair  was 
combed,  her  person  clean,  and  she  appeared  to  be  well  cared  for. 
Another  idiot,  u  young  man,  twenty-twn  years  old,  required  to  be  fed; 
his  hands  were  distorted,  and  he  hiid  no  use  of  his  lower  limbs;  he 
was  restrained  in  a  rocking  chair.  A  blind  woman  in  this  ward,  over 
ninety  vears  of  age,  required  constant  care  ;  her  clothes  had  been 
changed  three  times  on  the  day  of  visit.  Other  inmates  in  this  ward 
require  constant  attention.  Cleanliness  and  neatness  were  manifest 
throughout  the  department.  The  keeperof  tlie  poor-house  said  :  '"Our 
motto  is  'cleanliness,' and  we  think  we  have  pretty  well  carried  it 
out.  " 

The  visitation  was  made  by  Commissioner  Letchworth,  October  14, 
1881. 

Queens  County. 

The  county  asylum  for  the  insane  is  located  in  the  town  of  North 
Hempstead,  ten  miles  from  the  county  poor-house,  and  one  and  a 
half  miles  from  the  Mineola  post-office  and  railroad  station. 

The  wooden  structure  erected  in  1791  as  a  county  court-house  and 
occupied  as  such,  was  remodeled  in  1876  for  a  county  insane  asylum, 
at  an  expense  of  over  $7,000,  including  all  improvements  made  to 
the  present  time. 

The  main  building  is  sixty  feet  front  by  forty  in  depth,  with  exten- 
sions to  the  north  and  west  of  two  and  a  half  stories;  has  no  basement. 
It  is  surmounted  by  a  cupola  that  materially  assists  in  its  ventilation. 

A  cellar  twenty-five  feet  square,  which  is  used  for  milk,  bread,  fish 
and  some  vegetables,  is  under  the  superintendent's  reception-room  at 
the  south-wcst  corner  of  the  building.  During  the  winter  season  tur- 
nips and  cabbages  are  buried  outside  in  the  ground. 

The  rooms  upon  the  three  stories  vary  in  height  according  to  date 
of  construction,  and  the  objects  and  use  for  which  they  were  originally 
designed.  The  first  story  averages  nine  feet  in  height,  while  a  portion 
of  the  second  is  eleven  and  one-half,  the  remainder  from  eight  to 
eleven  and  one-half,  and  the  third,  which  was  unoccupied  space  until 
utilized  for  present  purposes,  is,  in  its  highest  part,  nine  feet,  sloping 
to  four  and  one-half  feet. 

The  superintendent's  reception  and  family  apartments  occupy  the 
front  of  the  main  building  upon  each  side  of  the  entrance  hall.  North 
of  these  and  at  the  left  is  the  dining-room  for  the  women,  and  an  ex- 
tension of  two  stories,  the  first  being  used  for  a  kitchen  and  bake-room. 
'J'he  kitchen  is  twenty-two  feet  by  twenty-one,  having  outside  windows 
upon  two  sides.  It  is  provided  with  a  range  of  suflicient  size  to  meet 
the  requirements  of  the  institution.  Forty  loaves  of  bread  can  be 
baked  at  one  time.  Upon  the  front  is  a  sink,  and  a  pump  that 
supi)lies  water  for  culinary  purposes  from  a  cistern,  is  situated  a  few 
feet  outside  of  the  building.  When  this  supply  is  exhausted  water  is 
forced  into  the  cistern  from  a  well  near  by.  The  bakery  opens  from 
the  kitchen.     The  newly-made  bread  was  tasted  and  found  good. 

The  building  is  warmed  by  heaters  u])on  the  first  fioor,  that  furnish 
hot  air  to  the  second  and  third  stories,  and  by  two  Baltimore  heaters 


Eeport  on  the  Chronic  Insane.  85 

that  deliver  heat  into  the  third  story  hall.  The  rooms  are  said  to 
have  been  at  all  times  sufficiently  warm.  The  degree  of  heat  is  not 
regulated  by  thermometers  in  tlie  wards. 

All  the  windows  are  adjusted  with  weights  and  pulleys. 

There  are  two  wards,  one  for  men  and  one  for  women.  The  ward 
for  men  consists  of  ten  rooms  located  in  the  three  stories.  The  rooms 
vary  in  size  and  in  the  numbci"  of  their  occupants.  There  are  no  sin- 
gle rooms.  The  two  rooms  on  the  lirst  floor  are  each  eleven  feet  by 
eight  and  one-half,  and  eight  feet  high,  with  a  capacity  of  seven  hun- 
dred and  forty-eight  cubic  feet  of  air  each,  and  one  hundred  and  eighty- 
seven  feet  per  inmate.  The  room  upon  the  second  floor  is  twenty-six 
by  twenty-three  and  one-half  feet,  and  eight  and  one -half  feet  high, 
with  nine  inmates.  At  the  east  are  two  large  windows,  near  the  door 
is  a  sink  with  three  faucets  for  toilet  purposes,  and  one  reclining  chair. 
The  entrance  door  opens  into  a  small  hall,  from  which  stairs  lead  to 
the  floors  above  and  below  ;  and  a  door  opens  upon  a  tin  roof  from 
which  a  lower  roof  may  be  reached,  and  thence  the  ground,  thus  form- 
ing a  fire-escape  that  has  been  proved  to  be  perfectly  safe  by  two  or 
three  patients  who  have  had  an  opportunity  to  use  it.  The  third 
story  has  a  central  hall  tifty-eight  feet  long  and  fourteen  high,  that  is 
well  furnished  with  wooden  settees,  chairs,  tables,  rocker,  and  a  lamp 
suspended  from  the  ceiling.  Large  windows  are  at  each  end  of  the 
hall,  and  a  cooler  containing  ice-water  is  upon  one  side.  The  rooms 
opening  upon  either  side  have  ceilings  of  nine  feet  at  the  highest 
point,  and  slope  from  about  half  way  to  four  and  one-half  feet.  Tran- 
soms are  over  each  door.  All  are  warmed  by  hall  registers  from  heat- 
ers on  the  first  floor.  Six  of  the  eight  rooms  on  this  hall  have  small 
windows.  No.  1  Is  an  attendant's  room  ;  No.  2  is  fourteen  feet  by 
eleven  feet  eight  inches,  with  five  beds  ;  No.  3,  of  the  same  size,  has 
four  beds  ;  No.  4,  fourteen  feet  by  seventeen  feet  six  inches,  has  six 
beds  and  a  large  window;  No.  5,  fourteen  by  sixteen  feet  eio-ht 
inches,  has  six  beds;  No.  6,  fourteen  feet  by"  fifteen,  has  six  beds; 
No.  ?  is  an  inclosed  passage  from  which  tiiere  is  a  stairway  to  the  cu- 
pola above,  that  is  arranged  to  form  a  fire-escape  into  the  hall  below 
by  raising  the  lower  steps;  No.  8  is  fourteen  feet  by  seventeen  feet 
nine  inches,  with  six  beds. 

The  ward  for  women  is  in  the  second  story,  and  consists  of  thirteen 
rooms  and  halls  of  irregular  sizes  and  shapes.  The  hall  upon  the 
second  floor  is  fourteen  by  eleven  feet,  less  a  stairway  taken  from  the 
south  and  west,  that  forms  a  part  of  the  fire-escape  from  the  third 
story.  The  various  halls  in  the  female  ward  are  furnished  with  wooden 
settees,  chairs,  tables  and  clocks.  Upon  the  left  is  an  irregular-shaped 
room  sixteen  by  twentj^-three  feet,  eleven  and  one-half  feet  high,  a 
stairway  having  been  taken  from  it.  It  has  seven  beds,  a  register  and 
a  window  opposite  the  door.  The  south-east  corner  room  upon  the 
same  hall  has  large  south  and  east  windows,  an  unused  fire-place  in  a 
chimney  and  a  register  ;  it  is  twenty  by  sixteen  feet,  and  eleven  and 
one-half  feet  high.  At  right  angles  with  this  hall  is  one  opening  from 
it  having  three  rooms,  two  of  which  are  occupied  by  attendants  ;  the 
third  is  thirteen  by  fourteen  feet,  eleven  and  one-half  high  ;  this  in 
addition  to  the  usual  furniture  has  a  i-ag  carpet  upon  the  floor.  Upon 
the  opposite  side  of  the  hall  is  an  associate  dormitory  fourteen  and 
one-half  by  twenty-nine  feet  with  twelve  beds,  and  two  large  grated 


86  Report  on  the  Chronic  Insane. 

west  windows  separated  by  a  chimney.  Upon  the  right  are  two  closets 
for  clothing  and  bedding,  one  for  the  use  of  the  inmates,  the  otlier 
opens  into  the  entrance  hall.  Upon  tiie  north  is  a  hall,  seven  and  one- 
half  feet  in  width,  with  an  outside  window.  Here  are  three  rooms, 
each  ten  and  one-half  by  nineteen  and  one-half  feet,  and  nine  feet  iiigh, 
each  containing  si.\  beds.  On  a  continuation  of  this  hall  in  the  exten- 
sion is  a  room  fourteen  by  fifteen  feet,  Ijy  eight  and  one-half  in  height, 
\»ith  four  beds  and  one  window,  anotlier  si.\  and  one-half  by  fourteen 
feet  (and  uthcns).  At  the  extreme  end  of  this  hall  is  a  wash-room  for 
the  insane  women,  in  which  is  a  sink  with  two  faucets.  This  communi- 
cates by  a  door  with  an  outside  closet  and  a  narrow  stairway  to  the 
ground.  Tiiis  stairway  has  been  condemned, and  it  is  to  be  replaced. 
Changes  are  contemplated  in  this  part  of  the  building,  in  order  to 
increase  the  accommodations  and  to  add  to  the  safety  of  the  inmates. 

South  of  the  kitchen,  and  twenty  feet  from  it,  in  an  inclosed  yard 
formerly  the  exercise  yard  for  insane  women,  is  a  one-story  wooden 
building,  one-half  of  which  is  the  store-room  for  blankets,  clothing, 
etc.,  while  the  other  half  is  for  the  storage  of  groceries.  The  build- 
ings are  not  fire-proof.  .\11  are  of  wood  with  partitions  lathed  and 
plastered. 

Contributions  of  papers  and  other  reading  matter  are  received  from 
the  local  committee,  and  friends  of  the  institution,  in  quantities  to 
meet  the  demand. 

Ventilation  is  secured  by  open  doors  and  windows  and  transoms 
over  each  door.  The  third  floor  has  a  grated  ventilator  through  the 
ceiling  into  the  cupola  above.  Upon  the  days  of  visitation  the  air  was 
generally  fresh  and  pure. 

There  are  no  rooms  designed  particularly  for  occupation  by  the  sick, 
they  being  cared  for  in  their  usual  rooms. 

The  bath-room,  eleven  by  eleven  and  a  half  feet,  is  situated  upon 
the  first  floor,  with  doors  opening  into  it  from  both  ironing-room  and 
hall,  and  has  one  bath-tub  in  which  patients  take  their  weekly  baths. 
Saturday  being  appropriated  to  the  men,  and  Monday  to  the  women. 
Frequent  baths  are  prescribed  at  other  times  by  Dr.  Rogers,  who  has 
faitli  in  the  soothing  and  medicinal  effects  of  cold  water,  and  who 
states  that  in  place  of  medicine,  baths  are  at  times  given  at  midnight, 
and  that  they  have  seldom  failed  in  producing  the  desired  effect  by 
bringing  to  the  patient  the  relief  of  sleep. 

The  laundry,  twenty-eight  by  eighteen  feet,  with  a  ceiling  of  eight 
feet,  is  situated  at  the  north-east  corner  of  the  building,  and  opens 
from  the  ironing-room.  It  is  supplied  with  stationary  wash-tubs  and 
pounding-barrels.  At  the  time  of  my  inspection  eight  men  were  at  the 
pounding-barrels,  two  at  each;  one  was  softly  humming  a  tune  to 
which  all  kept  time  with  their  pounders.  Two  women  were  washing 
in  the  tubs.  This  department  was  supervised  by  a  laundress  and  two 
attendants. 

The  insane  are  said  to  work  as  directed  and  according  to  their 
strength,  and  all  are  said  to  be  frequently  relieved. 

There  is  no  method  of  ascertaining  the  whole  (piantity  of  water  sup- 
plied for  each  day's  use,  or  that  of  each  patient.  Water  is  supjdied  by 
three  cisterns,  into  which  rain-water  is  received.  Two  wells  with 
pumps  in  each,  and  three  rubber  hose  for  use  in  case  of  fire,  also  con- 
vey the  water  forced  from  the   wells  to    fill    the  cisterns   if  required. 


Keport  on-  the  Chronic  Insane.  87 

A.t  both  the  south-east  and  south-west  corners  of  the  building  are  wells, 
3ftv-four  feet  deep  each,  and  about  fifty  feet  from  vaults.  There  are 
nclosed  vaults  in  each  airing  court,  and  at  the  south-west  corner  of 
the  building. 

The  system  of  sewerage  consists  in  the  conveying  of  water  from  the 
sinks  and  tubs  to  cess-pools,  so  arranged  that  water  can  be  drawn  from 
Due  to  the  otlier,  bv  which  process,  and  a  frequent  removal  of  the  sed- 
iment, it  is  said  thiit  a  iiealthful  and  satisfactory  sewerage  is  secured. 

Patients  have  no  work-rooms  or  places  of  resort  when  the  weather 
Joes  Qot  permit  their  being  in  the  exercise  yards.  Of  these  yards 
there  are  two,  one  hundred  by  one  hundred  and  twenty-five  feet  each. 
The  one  for  the  women  is  entirely  separate  from  that  of  the  men. 
There  is  a  large  shed  with  benches  underneath  in  the  center  of  each. 
Ice-water,  to  which  all  have  access,  is  in  each  yard. 

Outside  of  the  exercise  yards  there  is  no  ground  for  the  recreation 
3r  amusement  of  either  men  or  women. 

Protection  from  fire  consists  of  vigilance  upon  the  part  of  the 
officers,  a  paid  night-watchman,  three  hose  for  conducting  water  as 
pumped  from  the  wells,  and  two  Halloway's  fire  extinguishers,  with 
3xtra  charges  for  each,  two  fire-escapes,  and  the  usual  doors  and  stair- 
ways. 

The  dining-room  for  the  men  is  in  a  one-story  extension,  north  of 
the  main  half,  twenty  feet  by  twenty-nine,  height,  nine  feet.  That 
for  the  women  is  nineteen  and  a  half  feet  by  twenty-six  and  a  half 
feet,  and  joins  the  kitchen.  Each  has  pine  tables,  chairs,  and  white 
stoneware,  knives  and  forks  of  steel,  and  spoons  of  galvanized  iron. 
Pay  patients,  served  after  others  have  eaten,  are  furnished  with_  a 
greater  variety  of  food,  and  have  their  tables  covered  with  white 
cloths. 

The  superintendent  states  that  he  "adheres  to  the  printed  dietary 
scale  as  nearly  as  possible."     (See  Appendix.) 

The  medical  supervision  is  that  of  the  superintendent  and  of  Dr. 
Phillip  M.  Wood,  who  is  and  has  been  the  visiting  physician  since 
the  asylum  was  organized,  and  who  is  paid  by  the  visit.  The  sum 
paid  in  the  year  188U  amounted  to  $375,  for  medicines  and  medi- 
cal attendance  as  physician  and  surgeon.  His  visits  are  made  each 
alternate  day,  and  mo)-e  frequently  if  necessary. 

There  is  no  allowance  for  surgical  cases.  The  county  has  furnished 
instruments  for  surgical  and  accident  cases. 

Prescription  and  case  books  are  not  kept  in  the  institution.  Cer- 
tificates of  insanity  are  on  file,  and  a  registry  of  names,  age  and  res- 
idence made  as  patients  come  in,  remains  in  the  office.  Dr.  Wood's 
private  prescription  and  case  books  are  in  his  own  office.  There  are 
no  consulting  physicians.  The  medical  society  of  the  county,  con- 
sisting of  ninety  members,  has  an  active  interest  in  the  institution,  and 
regularly  appoint  a  committee  to  inspect  and  report  at  its  annual 
meetings. 

The  citizens  of  the  county  manifest  their  interest  by  visits.  The  in- 
stitution is  in  charge  of  Dr.  David  S.  Rogers,  the  superintendent,  who 
has  received  successive  annual  appointments  from  the  supervisors 
since  the  opening,  with  a  salary  at  present  of  $1,200  per  year.  The 
assistant  keeper  receives  $40  per  month  ;  the  baker,  $18;  the  laundry 
man,  $17,  and  the  laundry  woman,  $15  per  month. 
12 


88  Report  on  the  Chronic  Insane. 

The  three  male  aud  throe  female  attendants  are  in  three  grades, 
the  first  grade  receiving  $19  per  month,  the  second  $17,  and  the  third 
$15  per  month,  making  in  all  a  paid  force  of  fourteen,  whose  united 
salaries  amount  to  $3,200  per  annum.  The  duties  of  each  are  assigned 
by  the  supt.'rintcndt*nt,  and  are  performed  under  his  direction.  Paupers 
do  not  as.sist  in  the  care  of  the  insane. 

There  are  neither  cribs,  restraining  chairs,  nor  manacles  nor  cells 
and  dungeons  of  any  description  in  whicli  to  confine  the  insane.  In 
and  belonging  to  the  institution  are  two  pairs  of  muffs,  six  camisoles 
and  some  leather  straps.  It  is  said  that  the  superintendent  supervises 
all  restraint,  and  that  none  is  allowed  except  upon  application  to  him 
and  by  his  approval.  There  is  no  restraint  book  kept.  Upon  August 
3,  one  woman  paced  the  exercise  yard  in  a  camisole  dress  and  it  is  said 
to  be  also  necessary  to  confine  her  to  her  bed  with  straps  at  nigiit. 
Also  in  the  men's  "yard  sitting  upon  a  bench  was  a  man  who  was  con- 
fined by  a  waist  strap  to  a  post.  His  feet  having  been  frozen  and  par- 
tially amputated,  his  constant  efforts  to  escape  prevent  their  healing, 
and  hence  his  confinement. 

The  building  is  so  constructed  that  while  admitting  of  the  separa- 
tion of  men  and  women  in  rooms,  wards,  halls,  dining-rooms  and 
exercise  yards,  there  is  no  separation  while  at  their  work  in  the 
kitchen  and  laundry.  A  constant  supervision  is  said  to  be  maintained 
over  these  departments. 

Space  is  too  limited  to  admit  of  thorough  classification  of  either  the 
men  or  the  women.  There  is  no  apartment  set  apart  for  epileptic  or 
idiotic  patients. 

The  idiotic  are  retained  at  the  county  poor-house. 

Classification  is  determined  by  the  superintendent. 

Out-door  amusements  are  not  provided  for  either  men  or  women. 
In  the  asylum,  cards,  dominoes,  and  checkers  are  supplied.  It  is  said 
that  the  insane  men  care  more  for  games  than  the  women,  the  latter 
seldom  engaging  in  them. 

There  are  no  amusements  in  or  out  of  the  institution  that  are  par- 
ticipated in  by  both  men  and  women. 

Neither  wards,  rooms,  nor  grounds  are  ornamented  or  adorned. 

Insane  men  are  employed  in  gardening,  in  the  care  of  the  grounds 
and  in  stable  work.  In-doors  they  do  whatever  they  are  able  to  do. 
Women  have  no  out-door  employment  but  assist  in  housework. 

No  patient  is  able  to  perform  a  fair  day's  labor,  but  many  work  for 
short  periods.  It  is  said  that  continuous  work  would  be  unsafe. 
Nearly  all  can  work  a  portion  of  each  day.  Forty-four  women 
patients  can  each  perform  a  partial  day's  work. 

The  work  of  the  men  is  remunerative  in  that  vegetables  are  raised 
and  supplied  for  the  entire  family.  It  is  said  that  there,  are  resident 
twenty  men  and  women,  the  value  of  whose  labor  would  average  $10 
per  month  each,  and  in  addition  transient  labor  is  performed  by  the 
insane,  to  such  an  extent  as  to  obviate  the  necessity  of  a  greater  paid 
force  than  at  present  employed.  The  superintendent  directs  the  kind 
of  labor  each  is  to  perform  and  its  duration.  Labor  as  before  stated 
is  regarded  as  a  great  curative  agency. 

Earnings  are  not  set  apart  for  the  insane.  Labor  is  provided  as  a 
medical  remedy  but  it  is  too  fitfully  performed  and  too  irregular  and 
unreliable  to  receive  a  reward. 


Keport  on  the  Chronic  Insane.  89 

Upon  August  3,  I  visited  the  institution  as  one  of  a  committee  of 
the  State  Board  of  Charities,  consisting  also  of  Commissioner  Smith 
and  the  Secretary. 

Of  one  hundred  and  three  inmates  fifty-one  were  men  and  fifty-two 
women,  and  twenty  were  not  residents  of  the  county.  One  woman 
and  one  man  were  in  restraint,  one  woman  destructive  of  clothing. 
The  youngest  was  a  boy  of  17.  Sixty-five  have  at  some  time  been 
treated  in  State  asylums  and  thirty-eight  have  not. 

The  apartments  are  furnished  with  single  iron  bedsteads,  wooden 
chairs,  are  warmed  by  registers  or  from  the  hall,  and  lighted  by  kero- 
sene lamps  in  which  150  test  oil  is  burned. 

The  bedding  consists  of  straw  beds,  one  pair  of  sheets,  one  pillow 
and  case,  rose  blankets,  varying  in  number  as  required,  and  white 
counterpanes. 

The  clothing  varies  with  the  season,  and  is  not  of  any  fixed  or  dis- 
tinctive character;  flannel  is  provided  for  all  in  winter,  but  not  in 
the  summer  season. 

It  is  stated  that  the  insane  are  received,  being  committed  in  the 
usual  wav,  by  the  county  Judge,  upon  certificates  from  two  examining 
phvscians.  If  classed  by  the  superintendent  as  acute,  friends  are  com- 
municated with,  and  it  is  said  that  such  a  course  has  often  resulted  in 
clianging  their  condition  to  that  of  private  patients. 

Upon  Augnst  3,  twenty  of  the  inmates,  eight  women  and  twelve  men, 
were  pay  patients  ;  of  these  two  women  and  three  men  were  residents 
of  the  county,  and  six  women  and  nine  men  were  non-residents,  pay- 
ing from  ^3  to  S8  per  week.  These  boarders  are  said  to  receive  the 
same  treatment  as  the  public  patients,  with  the  exception  of  a  separate 
table,  better  food  and  Ireedom  to  work  as  they  will. 

Visited  by  Commissioner  Carpenter  August  3,  1881. 

Note.— The  contemplated  changes  have  been  made. 

Suffolk  County. 

The  institution  consisting  of  the  Suffolk  county  poor-house  and  its 
department  for  the  insane  is  located  upon  the  county  farm,  near  the 
railroad  station  at  Yaphank.  The  two  are  so  closely  associated, 
both  by  the  construction  of  the  building  and  by  the  government,  as 
to  render  it  impossible  to  report  either  separately,  for  combined  as  they 
are  under  one  roof  and  one  management  they  are  one  institution. 

The  main  building  or  poor-house  erected  in  1870  was  enlarged  in 
1877  by  the  addition  of  a  wing,  intended  for  the  use  of  insane  women. 
The  same  year  Suffolk  county  was  exempted  by  the  State  Board  of  Char- 
ities from  the  operation  of  the  Willard  Asylum   act  of  1871. 

The  insane  men  have  accommodations  in  the  main  or  poor-house 
building,  in  which  one-hall,"  the  old  hall"  is  also  set  apart  for  insane 
women.  Insane  men  have  no  separate  paid  male  attendant,  nor  care 
other  than  that  shared  by  the  sane.  They  dine  at  the  same  table,  are 
provided  with  the  same  food,  exercise  in  one  yard,  labor  in  one  field, 
and  are  under  one  keeper.  Necessarily  the  statement  of  facts  in  rela- 
tion to  provision  and  care  of  the  insane  must  include  to  a  great  degree 
that  of  the  sane. 

The  whole  structure  is  of  wood.  The  central  or  main  building  above 
the  basement  consists  of  three  stories  and  a  garret,  together  with  wings 


90  Report  on  the  Cheonic  Insa.ne. 

of  two  stories  and  a  garret.  A  basement  appropriated  to  the  various 
uses  of  storao:e,  work,  silting-rooms  and  rooms  for  insane  men  extends 
under  the  whole  structure.  The  portion  under  the  wing  for  insane 
women  may  properly  be  called  a  cellar,  with  small  windows.  It  is  of 
the  size  of  the  addition,  and  includes  the  milk  cellar,  furnace,  space 
for  a  few  vegetables,  and  storage. 

The  windows  throughout  the  institution  have  upper  and  lower  sashes, 
with  twelve  panes  of  glass  each,  eleven  by  fifteen  inches,  and  are 
adjusted  with  weights  ami  pulleys.     The  building  is  not  tire-proof. 

The  three  ap:irtments  for  insane  men  are  unlike  each  other,  and  are 
located  upon  different  floors  and  divisions  of  the  poor-house.  The  first 
is  upon  the  third  floor  and  was  fitted  up  for  the  use  of  insane  men 
December,  1880,  in  compliance  with  a  resolution  of  the  board  of  super- 
visors, dated  1879,  for  the  object  of  providing  rooms  to  be  used  in 
place  of  the  basement  cells.  It  is  ninety  feet  in  length  and  nine  and 
one-half  feet  high,  having  windows  at  each  end  of  a  central  hall 
twelve  feet  wide,  from  which  fourteen  single  rooms  o})en,  each  six  by 
fourteen  feet  and  nine  and  one-half  feet  high,  with  capacity  of  seven 
hundred  and  ninety-eight  cubic  feet  of  air  each  ;  and  one  associate 
dormitory,  ten  by  fourteen  feet  and  nine  and  one-half  feet  high,  with 
capacity  "of  one  thousand  three  hundred  and  thirty  cubic  feet  of  air, 
and  a  bath-room  the  same  size.  The  hall  window  opens  upon  a  fire- 
escape  ;  each  room  has  an  outside  window,  and  over  each  door  is  an 
open  grated  transom. 

The  second  is  upon  the  second  story  of  the  poor-house  department 
and  is  fifteen  by  twenty- nine  feet,  and  ten  feet  in  height,  with  three 
windows  five  feet  by  three  upon  the  south  side  ;  upon  the  day  of  in- 
spection it  was  occupied  by  six  insane  men  who  were  able  to  perform 
daily  work.  This  number  is  at  times  increased  to  twelve.  Its  capac- 
ity for  air  is  four  thousand  three  hundred  and  fifty  cubic  feet,  being 
seven  hundred  and  twenty-five  per  inmate.  It  is  supervised  by  the 
engineer,  who  also  has  charge  of  the  engine-room  and  the  men's  division 
of  the  poor-house. 

The  third  apartment  for  men  is  in  the  basement  of  the  poor-house, 
and  consists  of  eight  cells  or  rooms,  the  use  of  which  was  intended  to 
be  abandoned  upon  the  completion  of  the  new  hall.  This  ward  was  occu- 
pied upon  the  day  of  inspection  by  eleven  insane  and  four  feeble- 
minded or  demented  men.  Each  room  is  eight  and  one-half  by  fourteen 
feet,  and  eight  feet  high,  having  one  window  three  feet  square  above 
and  on  a  level  with  the  ground,  adjusted  with  weights  and  pulleys. 
The  floors  are  of  brick  and  the  partitions  are  plastered  upon  brick.  A 
slat  door  opens  from  each  room  into  a  hall  seven  and  one-half  feet  wide 
by  sevunty-five  feet,  communicating  at  each  end  with  large  rooms,  one 
of  which  is  used  as  a  sitting-room  by  men  and  has  a  door  opening  from 
it  into  the  men's  exercise  yard.  The  eight  rooms  are  occupied  by  one 
or  two  men  according  to  the  judgment  of  the  keeper,  and  all  are  oc- 
cupied by  violent  or  filthy  cases. 

Three  halls  are  occupied  by  insane  women,  one  of  which,  the  old 
hall  as  it  is  styled,  is  in  the  poor-house  department.  It  has  six  single 
rooms,  six  by  fourteen  feet,  with  capacity  of  eight  hundred  and  forty 
cubic  feet  each,  two  single  rooms,  nine  by  fourteen  feet,  with  capacity 
of  one  thousand  two  hundred  and  sixty  cubic  feet,  and  two  associate 
dormitories,  fourteen  by  seventeen  feet,  with  capacity  of  two  thousand 


Eepokt  on  the  Chronic  Insane.  91 

;hree  hundred  and  eighty  cubic  feet  of  air,  each  occupied  by  two  or 
three  inmates,  as  is  necessary.  The  hall  is  sixty  by  ten  feet  and  the 
aath-room  twelve  by  fourteen.  The  insane  of  this  ward  are  violent, 
?xcitable  and  filthy  cases,  in  charge  of  one  paid  attendant. 

The  ward  in  the  new  wing  has  sixteen  single  rooms,  each  six  by 
eleven  feet,  and  ten  feet  high,  with  capacity  of  six  hundred  and  sixty- 
cubic  feet  of  air.  and  eight  associate  dormitories  each  eleven  by  eleven 
feet,  with  a  capacity  of  six  hundred  and  live  cubic  feet  of  air  per  in- 
mate; each  room  has  a  window  and  a  transom  over  the  door.  Both 
halls  of  the  ward  are  in  charge  of  the  first  attendant,  assisted  by  the 
nurse. 

There  are  no  day  or  work-rooms  for  either  men  or  women,  who  pass 
the  time  in  the  exercise  yards  and  their  own  rooms  or  ward  halls. 
The  insane  men  may  if  they.please  occupy  the  brick  lloor  sitting-room 
in  the  basement,  midway  between  the  cells  and  shops,  that  being  for 
the  use  of  both  sane  and  insane. 

The  whole  institution  with  the  exception  of  the  new  wing  which 
is  warmed  by  a  furnace  in  the  cellar,  is  heated  by  steam  from  one  en- 
gine and  boiler.  Kegisters  are  in  the  halls  and  it  is  said  that  all  apart- 
ments have  been  sufficiently  warm.  Thermometers  are  in  use  during 
the  winter  season. 

The  ventilation  is  from  the  doors  and  windows.  Upon  August  24 
and  25,  the  air  was  generally  good. 

There  is  no  hospital  department. 

Tiie  bathing  arrangements  consist  of  bath-rooms  in  the  apartments 
for  women,  and  in  the  new  hall  for  insane  men,  in  which  are  stationary 
bath-tubs,  with  hot  and  cold  water.  Sinks  are  in  the  halls,  in  which 
are  hand  basins  and  water  faucets. 

The  laundry  is  in  common  with  that  of  the  poor-house  department. 
The  clothes  are  boiled  by  steam,  and  there  is  an  in-door  drying-room 
for  the  winter  season. 

Water  is  supplied  from  a  "  spring  well  "  in  the  engine-room  near 
the  boiler.  From  it  water  is  forced  into  the  three  tanks,  each  with  a 
capacity  of  three  thousand  gallons,  from  which  it  is  distributed  over 
the  institution.  About  one  tank  is  daily  filled.  The  water  is  said  to 
be  pure  and  good.  There  is  also  a  well  at  each  barn,  in  the  kitchen, 
and  one  is  placed  one  hundred  feet  from  the  front  of  the  poor-house. 
Cisterns  are  not  used. 

The  sewerage  or  drainage  consists  of  drain  pipes  to  an  open  pool 
sixteen  hundred  feet  distant,  said  to  be  properly  tapped.  Inclosed 
closets  are  at  the  extreme  of  each  airing  court,  that  are  said  to  be  daily 
cleansed,  and  the  sewage  conducted  by  pipes  to  the  pool. 

The  exercise  yards  are  inclosed  spaces  without  trees  and  covered 
with  grass.  The  one  for  sane  and  insane  men  is  one  hundred  and 
thirty  by  sixty-five  feet,  having  sheds  and  benches  underneath,  while 
one  sixty-five  feet  by  eighty,  with  a  shed  and  benches,  is  provided  for 
insane  women. 

The  groves  near  by  are  frequented  by  the  insane.  A  shaded  avenue, 
two  miles  in  length,  surrounds  the  farm  and  is  used  by  the  patients  in 
taking  exercise,  as  well  as  an  orchard  of  three  acres  in  which  the  fruit 
is  eaten  as  gathered.  These  grounds  are  said  to  be  open  to  all,  but  it 
is  understood  that  men  and  women  must  occupy  them  at  different 
hours. 


92  Report  on  the  Chronic  Iksane. 

There  is  no  paid  watchman. 

The  means  of  escape  in  the  event  of  a  fire  are  the  three  iron  fire- 
escapes  provided  the  past  year,  and  the  nsual  modes  of  egress  by  stair- 
ways and  doors.  The  keeper  overlooks  the  place  at  night  and  the  at- 
tendants sleep  upon  the  halls.  Ten  hose  are  in  order  in  the  institu- 
tion and  two  Babcock's  fire  extinguishers  have  been  provided. 

There  is  no  se])arate  kitchen  for  the  insane,  whose  food  is  prepared 
in  that  of  the  institution. 

The  dining-room  for  sane  and  insane  men,  fourteen  by  sixty  feet 
and  eleven  feet  high,  is  upon  the  first  floor.  It  is  distinct  from  that 
upon  the  opposite  side  of  the  kitchen,  fourteen  by  thirty  feet,  which 
latter  is  the  dining-room  for  the  pauper  women  and  the  insane  wo- 
men of  the  "old  hall." 

The  tables  are  of  uncovered  pine.  Stools  are  provided.  The  plates 
are  of  white-ware  and  the  knives  and  forks  are  of  steel.  Tin  cups  are 
furnished  for  the  men  and  white  bowls  for  the  women.  The  ward 
dining-room  has  a  table  covered  with  enameled  cloth  and  is  provided 
with  chairs.     The  table  is  furnished  with  white-ware. 

The  diet  is  prescribed  by  the  keeper  and  is  but  little  varied  for  the 
insane  men,  who  dine  at  the  same  table  with  the  sane  inmates  of  the 
poor-house.  Bill  of  fare  :  Monday,  dinner,  boiled  beef,  potatoes,  tur- 
nips in  their  season,  bread  and  tea.  Tuesday,  beef  stew  with  tea  and 
bread.  Wednesday,  beef  and  beef  soup,  bread  and  tea.  Thursday, 
beef  stews.  Friday,  fish  and  potatoes.  Saturday,  pork,  beans  and 
potatoes.  Sunday,  baked  beans  and  roast  beef,  bread  and  potatoes. 
The  daily  breakfast  consists  of  coffee  with  sugar  and  milk,  meat, 
hominy  and  molasses  or  milk,  bread  and  butter.  For  supper  each 
day,  tea,  bread  and  butter,  molasses  cake,  stewed  fruit  or  some  sauce. 

There  is  no  separate  diet  table  for  the  sick.  The  care  of  the  sick 
is  regulated  in  diet,  by  direction  of  the  physician  and  the  keeper.  The 
sick  are  given  all  the  milk  and  cream  they  can  use,  and  a  woman  is 
assigned  to  cook  for  them. 

The  medical  supervision  is  that  of  Dr.  James  B.  Baker,  who  for  ten 
years  has  been  the  visiting  physician  of  the  institution,  and  is  paid  by 
the  visit.  He  visits  alternate  days  and  daily  if  necessary.  Should 
consulting  physicians  or  surgeons  be  called,  bills  for  their  services  are 
presented  to  the  superintendents  of  the  poor.  Medicines  are  furnished 
by  the  county  and  are  given  out  by  Dr.  Baker.  There  is  no  extra 
allowance  "for  services  rendered  in  case  of  accident  requiring  surgical 
operations." 

The  institution  has  no  prescription  or  case  books.  The  insane  are 
registered  as  paupers  in  the  same  book  as  the  sane  and  are  distin- 
guished by  the  descriptive  word  "insane"  annexed. 

Certificates  of  insanity  are  on  file  in  the  institution. 

There  are  no  appointed  consulting  physicians.  The  interest  of  the 
medical  profession  in  the  county  has  been  manifested  from  time  to 
time.    The   medical  society  have   held  one  meeting  at  the  poor-house 

The  citizens  of  the  county  visit  frequently.  Wednesday  and  Thurs- 
day of  each  week  are  visiting  days.  At  times  the  number  of  visitors 
is  very  large  and  the  interest  is  said  to   continue  throughout  the  year. 

The  employees  for  the  insane  department  cannot  be  entirely  sepa- 
rated from  those  for  the  sane. 

The  keeper  at  $7oO  salary,  an  assistant  keeper  at  $550,  a  matron  at 


Report  on  the  Chronic  Insane.  93 

$250,  nurse  at  $150,  and  seamstress  at  $180  per  year,  all  have  their 
time  partially  occupied  in  the  performance  of  duties  which  extend 
over  the  whole  institution.  In  addition  to  these  there  is  a  farmer  at 
$350  per  year,  an  engineer  at  $300,  and  a  cook  at  $180,  whose  services 
are  for  all  the  inmates,  while  two  female  attendants  are  the  only 
paid  employees  whose  work  is  confined  exclusively  to  the  care  of  the 
insane.  Two  of  the  assistant  cooks  are  inmates  and  three  pauper 
men  and  three  pauper  women  are  detailed  to  assist  in  the  care  of  the 
insane,  and  one  woman  takes  charge  of  the  table  for  the  insane  women. 

All  employees  and  attendants  are  under  the  supervision  of  the  keeper 
who  regulates  the  conduct  and  prescribes  the  duties  of  each. 

There  are  no  secure  rooms  for  the  confinement  of  the  insane,  other 
than  their  sleeping-rooms.  There  are  no  cribs.  Two  wooden  restrain- 
ing chairs  with  leather  straps  are  screwed  to  the  floor.  The  two  pairs 
of  muffs  were  upon  the  date  of  inspection  out  of  order.  Six  camisoles 
are  said  to  be  occasionally  used  two  or  three  hours  at  a  time.  Of  the 
four  pairs  of  wrist  manacles  in  tlie  institution  two  were  in  use.  Be- 
sides these  means  of  restraint  the  county  owns  about  twenty  leather 
straps.  There  is  no  restraint  book.  The  two  dark  cells  have  not 
it  is  said  been  used  during  the  term  of  the  present  keeper,  who  states 
that  no  punishment  is  allowed  save  that  of  confinement  in  rooms. 

Separation  is  secured  in-doorsand  out.  Classification  is  determined 
by  the  keeper  as  sane  or  insane  according  to  habits  of  cleanliness,  de- 
gree of  insanity,  imbecility  and  violence,  and  is  regulated  and  re- 
arranged by  him  whenever  it  becomes  necessary  from  the  changed  con- 
dition of  the  patients.  The  idiotic  and  epileptic  have  no  separate  care, 
having  at  night  the  same  attention  as  other  inmates. 

Idiotic,  epileptic,  and  feeble-minded  children  are  assigned  rooms 
jn  the  insane  department.  Upon  the  date  of  inspection  a  girl  about 
fourteen  years  of  age,  an  epileptic,  idiotic  mute  was  with  the  in- 
sane and  a  boy  of  seven  years  of  age  was  in  the  charge  of  an  insane 
woman. 

The  out-door  amusements  for  men  consist  of  exercise  in  the  open 
air,  and  work.  Both  men  and  women  have  the  liberty  of  the  ground 
at  separate  hours.  Women  are  at  times  taken  to  drive  and  to  walk  by 
the  attendants. 

Games  and  other  in-door  amusements  are  not  provided  for  either 
men  or  women  or  for  both  in  common. 

All  who  wish  to  read  are  allowed  to  do  so.  Illustrated  and  county 
papers  are  taken  and  distributed  by  the  keeper.  Papers  and  magazines 
are  contributed  by  the  friends  of  the  institution. 

The  rooms  and  wards  are  not  decorated  or  adorned,  and  grounds  are 
not  set  apart  for  decoration  or  ornamental  purposes.  There  are  a  few 
plants  or  shrubs  by  the  rnaiu  entrance. 

The  insane  men  are  employed  in  farming,  stable  work  and  garden- 
ing, and  in  shoe,  carpenter  and  other  shops.  It  is  stated  that  vege- 
tables are  raised  upon  the  farm  sufficient  in  variety  and  quantity  for 
table  use.  The  women  are  employed  in  housework  and  sewing.  Upon 
the  day  of  my  visit  ten  men  were  able  to  do  a  fair  day's  work  atid  ten 
a  partial  day's  work.  Eight  or  ten  women  could  do  a  fair  day's  work 
and  nearly  all  of  the  women  or  twenty-five  could  do  a  partial  day's 
work. 

It  is  stated  ''the  labor  of  the  men  cannot  be  said  to  be  remunerative. 


94  Report  on  the  Chroxic  Insane. 

not  more  than  their  board,  it  may  save  $1,000 ;  they  work  upon  the 
farm  upon  wliich  vegetables  are  raised."  The  women  are  said  to  make 
all  of  the  clothes  of  both  men  and  women,  assist  in  the  housework 
and  perhaps  save  §i500  or  1600  a  year.  "All  the  men  labor  under  the 
direction  of  the  keeper  or  his  assistant,  the  women  under  that  of  the 
matron,  wiiose  supervision  prevents  their  over-work."  The  authorities 
regard  the  influence  of  labor  upon  the  insane  as  being  the  most  effi- 
cient of  all  curative  measures  in  operation  for  their  benefit  and  as  one 
that  meets  their  great  special  need. 

Upon  August  24,  1881,  fifty  insane  were  resident,  of  whom  twenty- 
eight  were  men  and  twenty-two  women. 

Eight  women  who  are  limited  to  the  halls  when  in-doors  are  allowed 
to  go  into  the  exercise  yard.  One  man  and  one  woman  were  confined 
to  their  rooms.  None  were  in  restraint  of  chairs,  seats  or  muffs.  The 
paroxysms  of  two  meu  made  handcuffs  necessary.  Since  August  24, 
three  men  who  were  in  restraint  have  been  taken  to  the  asylum  at 
Binghamton. 

Except  in  the  basement  cells  the  bedsteads  are  of  iron,  upon  which 
are  well-filled  straw  ticks  or  mattresses,  sheets,  pillow  and  case, 
blankets,  and  white  or  bine  plaid  cover.  In  some  instances  the  beds 
placed  in  the  rooms  at  night  are  destroyed  before  morning. 

Acute  cases  of  insanity  are  removed  to  State  asylums  immediately 
after  examination. 

Upon  August  24,  one  woman  and  one  man  were  pay  patients  at  the 
rate  of  $2.50  per  week  each,  whose  treatment  was  said  to  be  the  same 
as  that  of  the  other  insane. 

Non-residents  of  Suffolk  county  are  not  admitted. 

The  county  of  Suffolk  elects  three  superintendents  of  the  poor,  by 
whom  the  keeper  is  appointed. 

Visited  by  Commissioner  Carpenter  August  24,  1881. 

Wyoming  County. 

This  county  poor-house  is  located  in  the  town  of  Orangeville,  one 
mile  from  Varysburg  station,  on  the  Tonawanda  Valley  railroad,  and 
half  a  mile  from  the  small  village  bearing  the  same  name.  The  site 
of  the  building  is  somewhat  elevated,  affording  good  drainage,  and  the 
district  is  healthful. 

Officials  and  employes. —  The  administration  of  public  relief  in  this 
county  is  controlled  by  a  board  of  three  superintendents  of  the  poor. 
The  keeper  of  the  poor-house  is  appointed  by  the  board  of  sui)erin- 
tendents.  He  receives  8700  a  year  and  living.  He  has  general  charge 
of  the  establishment,  including  the  insane.  A  farm  hand  is  employed 
at  $20  per  month,  also  a  woman  at  82.50  per  week,  who  has  charge  of 
the  pauper  kitchen  and  dining-rooms. 

T'he  insane  department  is  under  the  immediate  charge  of  a  matron, 
who  receives  84  per  week,  and  occupies  rooms  in  the  building.  She 
has  one  female  assistant  who  is  paid  $2  per  week  and  has  also  rooms 
in  the  asylum.  Both  eat  at  the  keeper's  table.  There  is  an  additional 
attendant,  a  pauper,  said  to  be  "simple-minded,  but  useful  under  di- 
rection." The  farm  hand  attends  to  the  men  in  the  keeper's  absence, 
and  has  charge  of  them  when  at  work,  but  does  not  occupy  rooms  in 
the  asylum  building. 


Report  on  the  Chronic  Insane.  95 

Medical  supervision.— The  county  physician  is  apjininted  by  the 
board  of  superintendents,  and  is  required  to  visit  the  poor-house 
twice  a  week,  or  oftener  if  necessary,  and  to  furnish  such  medicines  free 
of  charge  as  are  not  kept  in  stock  at  the  county-house.  His  salary  is 
$100  per  year.  Medicines  are  dispensed  by  the  matron,  according  to 
the  physician's  orders.  Neither  prescription  l)ook  nor  ''  case  book  "  is 
kept.  There  are  no  consulting  physicians,  and  it  was  thought  that 
the  medical  profession  evinced  no  particular  interest  in  the  institution. 

General  description.  — T\\q,  department  for  the  insane  is  a  two-story 
frame  building,  thirty  feet  by  sixty  ft-et,  standing  forty  feet  west  of  the 
poor-house.  In  1880  it  was  enlarged  to  its  present  size  by  an  addition 
of  twenty-four  feet.  A  cellar  in  which  the  furnace  is  located  extends 
nnder  the  whole  structure.  Here  also  coal  is  stored,  and  in  winter 
or  rainy  weather  clothes  are  hung  to  dry.  A  covered  porch  for  each 
story  extends  the  entire  width  of  the  buildingat  its  rear,  overlooking 
the  yards. 

The  first  story,  occupied  by  male  patients,  is  entered  by  an  ante- 
room, separated  from  the  ward  l)y  a  partition  of  vertical  iron  rods  in 
which  is  a  grated  door.  A  hall  fourteen  feet  wide  extends  through 
the  center,  into  which  open  twelve  rooms,  six  on  each  side.  Tliese 
rooms  vary  in  size,  averaging  seven  and  a  half  feet  square,  and  to- 
gether with  the  hall  are  ceiled  throughout  with  matched  boards  and 
painted.  The  window-sashes  in  the  older  portion  are  of  wood,  pro- 
tected on  the  inside  by  a  frame  of  vertical  iron  rods,  secured  by  a  pad- 
lock, while  in  the  new  part  both  upper  and  lower  sashes  are  secured 
by  locks.  The  doors  in  the  old  part  are  of  triple  thickness,  with 
grated  openings  in  the  center  ;  in  the  new,  they  are  paneled  and  have 
transoms,  six  by  thirty-two  inches. 

The  hall  was  furnished  with  a  pine  table,  plain  wooden  chairs,  and 
an  arm-chair.     The  walls  were  bare. 

The  second  story,  reached  by  a  staircase  from  the  ante-room  on  the 
first  floor,  is  allotted  to  the  female  patients.  A  broad  hall,  similar  to 
that  on  the  floor  below,  extends  through  the  center,  with  rooms  on 
each  side.  At  the  front  end  is  a  sitting-room,  with  an  adjoining  sleep- 
ing apartment  for  the  matron.  The  hall  is  furnished  with  cane-seat 
chairs  and  a  long  pine  table,  while  hanging-baskets  suspend  from  the 
windows.  The  floor  is  bare,  as  are  also  the  walls,  with  exception  of 
two  large  oil-portraits,  which  were  left  by  a  former  patient.  The 
sleeping-rooms  on  this  floor  are  about  the  same  size  as  those  below. 
They  have  iron  bedsteads  and  simple  furniture.  Some  were  provided 
with  cushioned  rocking-chairs,  a  piece  of  rag-carpet  on  the  floor,  and  a 
few  trinkets.  Dresses  hung  upon  the  walls  and  occasionally  flowers 
were  seen,  transplanted  in  tea-cups  or  old  bottles.  One  of  these  rooms 
was  remarkably  neat,  and  contained  a  number  of  objects  illustrating 
the  brighter  side  of  home  life.  The  floor  was  covered  with  rag-carpet, 
and  the  walls  adorned  with  cheap  pictures  in  improvised  frames,  fancy 
slippers  containing  dried  grasses,  and  a  variety  of  other  ornaments. 
Upon  a  small  table  with  snow-white  cotton-spread,  lay  a  variety  of 
illustrated  papers.  Several  dolls,  neatly  dressed,  a  work-box,  a  well- 
worn  Bible,  a  copy  of  the  Pilgrim's  Progress  and  a  book  of  sacred 
songs  were  among  the  other  articles  observed  here.  A  cane-seat 
rocking-chair,  and  a  trunk  full  of  clothing  gave  further  hints  of  com- 
fort. 

13 


96  Report  on  the  Chronic  Insane. 

About  sixty  feet  to  the  right  of  the  insane  department  is  a  one- 
story  frame  structure,  twenty-four  by  thirty-six  feet,  for  the  care  of 
idiotic  females.  The  sitting-room  in  front  and  two  small  rooms  ad- 
joining, are  occupied  by  two  pauper  attendants.  The  ward  for  the 
idiotic  is  separated  from  this  portion  of  the  building  by  a  grated  par- 
tition, witii  grated  door.  A  heating-pipe  from  a  cook-stove  in  the 
sitting-room  passes  through  the  ward  to  a  chimney  in  the  farther 
end.  It  was  stated  that  in  winter  a  large  box-stove  is  substituted  for 
the  cook-stove.  The  ward  is  twenty  feet  by  ten  feet,  ceiled  and  painted. 
On  each  side  are  small  rooms  seven  by  seven  and  a  half  feet,  and  ten 
feet  high  also  ceiled  and  painted.  The  windows  are  grated  and 
measure  two  feet  three  inches  by  twelve  inches.  The  doors  are  of 
triple  thickness  of  boards,  with  openings  seven  by  fourteen  inches. 
They  are  secured  by  hasp  and  padlock.  Underneath  the  doors  is  a 
space  of  two  inches,  and  above  are  transoms  six  by  thirty-six  inches. 
A  circular  aperture,  seven  inches  in  diameter,  overhead  in  each  room, 
opens  into  an  attic,  for  ventilation.  The  rooms  are  fitted  up  with 
wooden  bunks,  and  provided  with  straw-beds  and  necessary  bedding. 

In  the  rear  is  a  yard  sixty-three  by  ninety-seven  feet,  inclosed  by  a 
board  fence,  nine  feet  high.  In  the  center  is  a  pavilion  with  seats. 
The  yard  is  grassed  and  has  graveled  walks  around  the  sides. 

The  yard  for  female  inmates,  of  similar  size,  is  inclosed  on  the  south 
and  west  sides  by  a  tight  board  fence,  and  on  the  north  side  by  a  fence 
pailiug  nine  feet  in  height.  In  the  center  is  a  pavilion  with  vines 
growing  about  it.  Flower-beds  were  also  noticed.  The  walks  are 
graveled. 

The  yard,  for  the  insane  men,  ninety-seven  by  fifty  feet,  is  situated 
between  those  for  the  insane  women  and  the  idiotic  females.  A 
tight  board  fence,  nine  feet  high,  incloses  it,  and  a  pavilion  occupies 
the  center. 

Heating  and  ventilation. — The  building  is  heated  by  a  furnace.  Ther- 
mometers are  kept  in  the  wards,  but  no  daily  record  of  temperature  is 
taken  or  recorded. 

Dietary. — The  food  for  the  insane,  cooked  in  the  keeper's  family 
kitchen  and  served  in  the  wards,  was  described  as  consisting  of  beef, 
pork,  potatoes,  white  and  brown  bread  with  butter,  for  breakfast  and 
dinner  ;  bread,  corn  mush  and  milk  and  sauce  for  supper.  Beef  soup  is 
served  twice  a  week  ;  pork  and  beans,  once  a  week  ;  fried  cakes,  cookies, 
and  pie,  once  a  day;  tea  and  coffee,  if  desired  ;  beets,  turnips,  cabbage, 
carrots,  and  occasionally  tomatoes.  In  the  winter,  apples  are  furnished 
according  to  the  supply.  The  diet  for  the  sick  is  regulated  by  the 
physician.  Crockery,  pressed  tin  basins,  ordinary  knives  and  forks 
comprise  the  table  ware.  The  tables  are  laid  without  cloths.  Wood 
chairs  are  used  for   seats. 

Clothing. —  The  keeper  gave  the  clothing  as  follows:  "The  men  in 
summer  wear  check  shirt,  cottonade  pants  and  vest,  denim  frock,  cot- 
ton socks,  boots  or  shoes.  Those  not  working  wear  slippers.  In  win- 
ter, woolen  sack  coat,  lined  pants,  vest,  check  shirt,  woolen  wrapper, 
socks,  boots  and  lined  leather  mittens.  The  women,  in  summer,  wear 
a  calico  dress,  cotton  underwear,  cotton  stockings,  shoes  or  slippers, 
and  in  winter,  calico  dress,  woolen  under  skirts,  cotton  flannel  wrap- 
pers and  drawers,  woolen  stockings  and  shoes.  It  is  sought  to  have 
variety  rather  than  uniformity  in  dress.  Some  of  the  men  wear  woolen 


Report  on  the  Chronic  Insane.  97 

clothing  all  the  year  round."     The  ftttire  of  the  patients  appeared 
in  good  order   and  cleanly. 

Bedding.  —  The  bedsteads  tliroiighout  the  building  are  of  iron. 
The  bedding  comprised  a  tick  filled  with  straw,  thin  mattress,  sheets, 
pillow  and  case,  coverlet,  over  which  is  a  counterpane  for  day  use 
only.  In  the  winter,  it  was  said,  "additional  covering  is  used,  as  neces- 
sity requires." 

Employment— T\\Q  men  are  employed  in  general  labor  upon  the 
farm,  as  hoeing,  haying,  harvesting,  milking,  picking  up  stones,  etc., 
but  none  are  permitted  to  use  the  teams  in  plowing. 

The  keeper  said  none  of  "the  men  perform  a  fair  day's  labor,  and 
but  five  can  do  a  partial  day's  work.  The  labor  of  the  men  altogether 
would  not  equal  that  of  one  able-bodied  man,  while  that  of  the  women 
is  only  equal  to  about  one  hired  servant.  The  hired  man  personally 
directs  the  labor  of  the  men.  The  poor-house  farm  comprises  two  hun- 
dred and  eighty  acres  of  rolling  table-land  lying  at  the  junction  of 
Tonawanda  and  Stony  creeks.  The  women  work  under  the  direction 
of  the  matron,  or  her  assistant.  Their  work  consists  principally  of 
ironing.  If  a  tendency  to  overwork  is  exhibited,  it  is  checked,  and 
watch  is  kept  for  that  purpose.  Labor  is  thought  to  be  highly  bene- 
ficial ;  the  inmates  are  better  when  at  work  than  when  idlej!  if  not 
overworked." 

Restraint. —  Jfo" special  restraint"  it  was  said  is  used.  But  one 
woman  was  secluded  in  her  room  at  the  time  of  the  visit.  There  were 
in  the  insane  department  one  crib,  one  muff,  a  restraining  appliance 
of  iron  and  leather,  a  chain  with  ring  at  each  end,  and  straps  to  buckle 
around  the  ankles.  The  keeper  said  :  "  We  have  three  or  four  pairs 
of  handcuffs,  which  have  not  been  used  in  a  year."  He  further  stated, 
that  he  directed  the  restraint,  and  in  case  of  disobedience,  he  some- 
times punished  the  offender  by  showering  him  with  a  hose  from  the 
water-works.  This  was  used  by  the  keeper  alone.  His  metbod, 
he  said,  was  to  "  strip  the  patient  bare,  and  shower  him  until  he  gave 
up;"  but  he  said  '' This  punishment  is  rarely  used."  Sometimes  the 
muS"  is  used,  as  circumstances  require. 

Water  supply. —  The  water  supply  derived  from  springs  consists  in 
part  of  the  gravity  system,  with  reservoir  of  six  hundred  barrels  capac- 
ity, and  twenty  feet  head.  The  water  is  carried  to  the  building  in 
one  and  a  half-inch  iron  pipes,  and  the  supply  was  said  to  be  fully 
adequate.  There  are  also  two  wells,  one  six  feet  from  the  wash-house, 
and  another  between  the  horse  and  stock  barns.  Twenty  barrels  daily 
are  required  for  the  use  of  the  institution.  Eain  water  is  utilized  by 
means  of  cisterns.  The  poor-house  and  insane  departments  have  three 
hundred  feet  of  three-fourth-inch  rubber  hose,  for  use  in  case  of  fire. 
The  elevation  of  the  reservoir  being  only  twenty  feet,  it  is  deemed  of 
little  service  for  such  an  emergency. 

Sewerage. —  A  large  sewer  extends  from  the  wash-house  a  distance 
of  fifty  rods.  To  this  the  slops  from  the  kitchen  are  carried  in  pails 
and  emptied.  The  contents  of  the  night  vessels  are  utilized  upon  a 
compost  heap. 

General  ohservations. —  The  total  number  of  insane  in  the  poor- 
house  at  the  time  of  examination  was  twenty-one  ;  of  these,  eleven 
were  men  and  ten  women. 


98  Report  on  the  Chroxic  Insane. 

A  separation  of  the  sexes  is  maintained.  No  amusements  sepa- 
rately or  in  common  are  provided  for  either  sex. 

Tlie  clothes  of  the  insane  are  washed  at  the  wash-house  pf  the  poor- 
house  department. 

No  bath-tubs  nor  bathing-rooms  are  provided.  The  able-bodied  pa- 
tients bathe  in  tubs  at  the  wash-house  ;  the  others  in  their  rooms. 

Paying  patients,  residents  of  the  county,  are  received,  paying  an 
average  rate  of  §2  per  week,  according  to  the  ability  of  the  patient, 
or  the  circumstances  of  friends.  They  are  treated  precisely  like  the 
other  patients,  though  extras  may  be  furnished,  if  paid  for. 

Paying  patients  from  other  counties  are  taken,  who  are  charged 
$2.50  per  week  for  board,  with  clothing  extra.  At  the  time  of  our 
visit,  there  were  four  paying  patients,  all  men,  from  this  county,  and 
three  paying  patients  from  Genesee  county.  The  total  amount  received 
from  paying  patients  during  the  year  ending  June  30.  1881,  was 
$703. 

The  insane  are  registered  in  the  keeper's  office  at  the  poor-house. 
The  certificates  of  insanity  are  on  file  in  the  office.  'The  physician 
said:  "We  have  no  acute  insane."  The  certificates  do  not  always 
show  whether  a  case  is  acute  or  chronic.  For  the  past  year  the 
county  judge  has  approved  the  physician's  certificates,  and  sent  them 
to  the  poor-house,  instead  of  elsewhere,  as  heretofore.  Under  this 
method  it  is  possible  for  acute  cases  to  be  retained  in  the  insane 
department,  contrary  to  statute. 

In  fact,  the  local  visiting  committee  did  report  to  the  Board  that  a 
case  of  acute  insanity  was  retained,  and  that  it  appeared  to  be  one 
that  might  be  benefited,  if  transferred  to  a  State  asylum.  A  letter 
of  inquiry  was  at  once  addressed  to  the  county  physician,  who  was 
ignorant  of  any  infraction  of  the  statute.  "Further  investigation 
substantiated  the  fact,  that  a  patient  had  been  admitted  to  the  insane 
department  of  the  poor-house,  October  19,  1880;  and  after  remaining 
eleven  months,  was  transferred  to  the  insane  asylum  at  Buffalo, 
August  11,  1881.  Injustice  to  the  superintendents  of  the  poor,  it 
should  be  stated  that  the  committal  and  physician's  certificate  did 
not  set  forth  whether  the  case  was  acute  or  chronic. 

The  local  visiting  committee  of  the  State  Board  of  Charities  visit 
the  poor-house  occasionally  ;  they  also  send  papers  and  periodicals  for 
the  use  of  the  inmates. 

The  visitation  was  made  by  Commissioner  Letchworth,  September 
5,  1881. 

CONCLUSIONS. 

A  retrospective  glance  over  the  whole  examination  shows  that,  with 
few  exceptions,  the  care  of  the  chronic  insane  in  the  counties  does  not 
attain  to  a  just  and  proper  standard.  In  some  counties  the  deficiency 
is  lamentable.  It  should  be  kept  in  mind,  however,  that  many  of  the 
counties  applied  to  the  Board  for  exemption  from  the  operation  of  the 
Willard  Asylum  Act  as  a  temjjoranj  measure,  intending  to  provide 
for  their  chronic  insane  at  the  poor-house  until  such  time  only  as  the 
State  should  receive  them  under  its  care.  It  would,  therefore,  per- 
haps be  unjust  to  exact  as  large  an  expenditure  on  buildings  under 
such  circumstances,  as  would  have  been  proper  had  permanent  pro- 


Report  ox  the  CnRON'ic  Insane.  ^  99 

vision  been  contemplated.  It  must  also  be  remembered,  that  at  no 
time  since  the  Board  was  empowered  to  grant  the.se  exemptions,  has 
the  State  been  able  to  accommodate  the  insane  of  the  exempted  coun- 
ties in  its  institutions.  The  Board,  therefore,  has  not  been  able  to 
present  to  the  county  authorities  the  alternative  of  adopting  such  a 
standard  of  care  as  it  might  deem  satisfactory,  or  to  order  the  removal 
of  the  chronic  insane  to  the  State  institution. 

Unsatisfactory  as  are  the  results  of  the  examination,  as  a  whole, 
your  committee  would  not  advocate  the  suspension  or  revokement  of 
the  licenses  already  granted.  To  do  so  would  leave  the  insane  of  such 
counties  in  one  sense  beyond  the  protection  of  the  Board,  and  its  op- 
portunities for  frequent  conference  and  consultation  with  the  local 
authorities  would  be  interrupted.  The  history  of  the  care  of  the 
chronic  insane  will  show  that,  with  hardly  an  exception,  there  has 
been  a  steady  improvement  in  every  county  exempted  by  the  Board. 
The  committee  would,  therefore,  recommend  that  legislative  action 
should  be  sought  to  enable  the  Board  to  remove  existing  evils,  and,  till 
that  time,  to  continue  its  protests  and  appeals  to  the  local  authorities 
to  elevate  their  standard  of  care  for  the  chronic  insane. 

The  examination  has  led  the  committee  to  the  conclusion  that  both 
on  humane  and  economic  grounds  the  insane  cannot,  as  a  class,  be 
treated  under  a  uniform  system  adapted  to  sane  paupers,  and  that  it  is 
desirable  to  separate  them  from  the  poor-house  system  for  the  follow- 
ing reasons: 

First.  The  brief  term  for  which  superintendents  of  the  poor  are 
elected  to  oflBce,  and  the  frequent  changes  occurring  in  poor-house 
officials  and  employees. 

Second.  The  tendency  to  distribute  patronage  in  the  employment 
of  officers  and  attendants,  and  in  the  purchase  of  supplies,  as  rewards 
for  political  services  and  for  strengthening  partisan  influence. 

Tliird.  The  lowering  of  a  proper  standard  of  care  for  the  insane  to 
that  suitable  for  sane  paupers  would  obviously  be  unjustifiable  ;  while, 
on  the  other  hand,  abnormally  raising  the  standard  of  the  sane  to  that 
of  the  insane,  would  be  unnecessarily  expensive. 

Fourth.  The  necessity  for  special  care  and  treatment  of  the  insane 
directed  by  medical  authority. 

The  committee  further  conclude,  that  the  welfare  of  the  chronic 
insane  and  the  interests  of  the  pul)lic  will  be  promoted,  by  the  adop- 
tion of  the  following  principles  as  a  basis  of  action,  in  the  future  care 
of  this  class  of  dependents. 

First.  The  enlargement  of  State  provision  by  means  of  plain, 
inexpensive  buildings,  with  good  sanitary  surroundings  and  located 
upon  tracts  of  good  arable  land  should  be  sufficient  for  the  accommo- 
dation of  all  counties  desiring  to  place  their  chronic  insane  under  State 
care. 

Second.  That  the  chronic  insane  should  not  be  retained  by  coun- 
ties in  groups  numbering  less  than  two  hundred  and  fifty  (250), 
thereby  admitting  of  better  classification,  a  better  systemization  of 
labor  with  industrial  employment  adapted  to  winter  as  well  as  sum- 
mer, resulting  in  larger  products,  also,  securing  an  economic  ad- 
vantage, by  inviting  competition  in  the  purchase  of  supplies  in  large 
quantities,  together  with  the  greater  per  capita  saving,  always  attain 
able  in  providing  for  a  considerable  number  instead  ol  for  a  few. 


100  Report  on  the  Chronic  Insane. 

Third.  That  counties  having  a  smaller  number  of  chronic  insane, 
desiring  to  provide  other  tluin  State  care,  should  be  permitted  to  unite 
and  form  a  district  asylum. 

Fourth.  That  the  control  and  management  of  all  county  and  dis- 
trict asylums  sliould  be  placed  under  a  smull  board  of  uncompensated 
managers,  either  elected  by  the  peojjle  and  non-partisan,  or,  appointed 
by  a  full  bench  of  one  of  the  branches  of  the  judiciary,  or,  appointed 
by  the  Governor  —  in  any  case  the  term  of  oHice  to  be  long;  the 
asylums  so  controlled  and  directed  to  be  subject  to  the  same  rules  and 
regulations  as  the  State  institutions  for  the  chronic  insane. 

Fifth.  That  in  all  cases  the  chronic  insane  should  be  placed  under 
the  immediate  charge  of  a  resident  medical  superintendent,  having 
the  api)ointment  and  entire  control  of  the  subordinate  force. 

Sixth.  That  violent  and  disturbed  cases  should  be  provided  for  in 
appropriate  State  asylums,  having  special  provision  for  their  care, 
their  presence  in  county  institutions  interrupting  orderly  administra- 
tion, and  defeating  the  ends  of  economy. 

Seventh.  That  all  county  asylums  should  not  only  have  a  separate 
board  of  management  from  the  poor-house  establisliment,  but  that  their 
financial  system  should  also  be  separate,  and  that  all  asylum  buildings 
hereafter  erected  should  be  elscwliere  located  than  upon  the  poor-house 
farm. 

Respectfully  submitted, 

WM.  P.  LETCHWORTH, 
SARAH  M.  CARPENTER, 
CoDwiittee. 

Albany,  Decemler  5,  1881. 


SUPPLEMENT  TO  REPORT  ON  THE  CHRONIC  INSANE 
IN  COUNTIES  EXEMPTED  FROM  THE  WILLARD  ASYLUM 
ACT. 

Form  of  ''Medical  History"  of  Insane  Patients  Prepared  for 
THE  Chautauqua  County  Poor-house. 

By  Charles  T.    Wilson,  M.  D.   County  Physician. 

Medical  History  of 

Date, Age, Color, Born  in 

Residence, . . .   Occupation, Married  .   ...  No.  of  Children,. . . 

Date  of  last  confinement.  ..Height.  .Weight.  ..Color  of  Hair.  ..Eyes. . 

Date  of  Commitment, By  whom 

Drs and 

History  Antecedent  To  Present  Disease. 

General  Health, Hereditary  Predisposition, 

Previous  Disease Injuries, 

Habits Mode  of  Life 

Hygienic  Influences  to  which  exposed 


Report  on  the  Chronic  Insane.  101 


History  of  Present  Disease. 

Supposed  Exciting  Cause 

Date  of  Seizure 

Mode  of  Invasion 

Subsequent  Symptoms  in  order  of  occurreuce 


Previous  Treatment. 


Present  Condition  —  General  Symptoms. 

)  Out  of  Bed 

Position,  >■ 

)  In  Bed 

)  Of  Countenance 

Aspect.   >■ 

)  Of  Body 

Skin Pulse 

Tongue 

Respirations 

^  Appetite 

General   State  of  )■  Thirst 

Digestion        J  Bowels 

General  State  Urinary  Secretion 

Sensations  of  Patient 

Examinations  of  Special  Regions  or  Functions,  commencing  with  one 
presumably  most  affected 

Diagnosis, 
treatment. 

Remarks — [''These  should  include  previous    history  of  friends  re- 
ferring to  tendency  of  patients."] 

Rules  and  Regulations  of  the  "Erie  County  Insane  Asylum" 
FOR  Attendants  and  Assistants.  Their  Duty  to  the  Insti- 
tution. 

1.  All  persons  employed  in  the  asylum  are  expected  to  do  all  they 
can  to  promote  the  welfare  of  the  insLitution  :  treat  the  officers  on  all 
occasions  with  respect  and  politeness,  and  do  readily  and  cheerfully 
any  duty  required  of  them. 

2.  All  must  expect  an  unceasing  observation  of  the  manner  of  per- 
forming their  duties;  and  suggestions,  by  an  officer,  of  deficiencies  or 
improvement  therein  are  to  be  taken  kindly  and  without  offense,  and 
efforts  made  to  improve. 

3.  In  the  first  place  self-respect  is  enjoined  on  all.  Each  one  shall 
be  responsible  in  his  or  her  department  and  should  be  ambitious  to  do 
the  duties  of  it  to  entire  acceptance.  Let  your  dress  always  be  neat 
and  clean. 

4.  Avoid  all  ungentlemanly  habits,  such  as  wearing  hats  within 
doors,  going  in  shirt  slevees,  etc.  Never  indulge  in  loud  talking  or 
laughing  ;  use  no  profane,  obscene  or  vulgar  language.  Treat  each 
other   with  politeness ;  be  civil,  cordial  and  frank.     Cherish  a   high 


102  Report  os  the  Chronic  Insai^e. 

sense  of  moral  obligations  ;  cultivate  a  humble,  self-denying  spirit ;  seek 
to  be  useful  and  maintain  at  all  hazards  your  purity,  truth,  sobriety, 
economy,  faithfulness  and  honesty.  Patients  look  to  attendants  for 
good  example  ;  let  the  attendants  be  careful  in  nothing  to  set  a  bad 
one. 

5.  The  attendants  are  to  treat  the  inmates  with  respect  and  atten- 
tion ;  greet  them  cheerfully  with  "good  morning,  "  or  "  good  evening," 
and  show  tliem  such  other  mark  of  good-will  and  kindness  as  evince 
interest  and  sympathy.  Under  all  circumstances  be  kind  and  consid- 
erate ;'speak  in  a  mild  and  persuasive  tone  of  voice;  never  address  a 
patient  rudely.  A  patient  is  ever  to  be  soothed  and  calmed  when 
irritated;  encouraged  and  cheered  when  melancholy  or  depressed. 
They  must  never  be  pushed,  collared  or  rudely  handled. 

6.  If  the  attendant  receives  insults  and  abusive  language,  he  must 
keep  cool,  forbear  to  recriminate,  to  scold  or  dictate  in  the  language 
of  authority.  Violent  hands  are  never  to  be  laid  on  a  patient,  under 
any  provocation.  A  blow  is  never  to  be  returned,  nor  any  other  insult. 
Sufficient  force  to  prevent  patients  injuring  themselves,  or  others,  is 
always  to  be  applied  gently  ;  all  struggling  with  patients  should,  if 
possible,  be  avoided,  by  calling  additional  assistance,  when  a  patient  is 
highly  excited  or  disposed  to  violate,  before  entering  his  room  or  at 
tempting  to  dress  or  control  him. 

7.  On  rising  in  the  morning  it  is  the  duty  of  attendants  to  see  that 
each  patient  confided  to  his  or  her  care  is  thoroughly  washed,  hair 
combed,  clothes  cleaned,  and  in  fact  that  the  whole  dress  be  neat  and  in 
good  repair.  The  patients'  beds  are  then  to  be  made,  and  the  wards, 
bathing-rooms,  closets,  passages  and  stairs  to  be  swejot,  and  the  whole 
premises  to  be  put  in  complete  order,  as  soon  as  it  can  be  done.  No 
part  of  the  asylum  shall  be  considered  clean  if  it  can  be  made  cleaner. 

8.  One  attendant  must  always  be  in  each  ward  with  the  patients, 
and  must  not  leave  under  any  circumstance  until  relieved.  The  at- 
tendants must  not  retire  to  tlieir  rooms  while  the  patients  are  in  their 
wards,  only  long  enough  to  adjust  their  own  dress.  All  the  hours, 
with  this  sole  exception,  should  be  devoted  to  the  patients  to  keep 
them  tidy  and  comfortable,  to  prevent  improper  conduct,  such  as 
lying  on  the  floor  or  ground  ;  to  interest  and  amuse  them  by  reading  or 
talking  to  them  and  the  like.  They  are  responsible  for  the  safe-keep- 
ing of  the  patients,  and  must  not  leave  them  except  in  care  of  some 
responsible  person. 

9.  Visitors  will  not  be  admitted  on  Sundays  or  legal  holidays.  The 
keeper,  or  such  persons  as  he  will  designate,  will  show  visitors  through 
the  asylum.  Under  no  circumstances  will  the  attendants  be  allowed 
to  receive  or  entertain  company  in  the  asylum,  except  in  the  adminis- 
tration building.  Male  attendants  will  not  enter  the  female  depart- 
ment, except  on  duty,  or  with  permission  from  the  keeper,  or  physi- 
cian. Persons  wisliing  to  see  patients,  or  learn  their  condition,  will  in- 
quire for  the  keeper,  physician  or  matron,  and  information  concerning 
patients  will  not  bo  given  except  to  relatives  or  family  friends  and  pub- 
lic officers,  and  such  information  will  be  given  only  by  the  keeper  or 
physician. 

10.  The  physician  will  tend  to  the  patients  that  are  in  the  hospital, 
and  he  will  also  visit  the  wards  twice  each  day,  and  oftener  if  neces- 
sary.   The  attendants  will  each  day  report  to   him  all  manners   of 


Report  on  the  Chronic  Insane.  103 

restraint  and  name  of  each  person  so  restrained.  They  will  notice  the 
habits  and  conduct  of  patients,  and  inform  the  physician,  at  his  dailv 
visits,  of  all  circumstances  requiring  attention,  such  as  loss  of  appetite", 
or  any  indisposition,  etc.,  etc., 

11.  At  meals  the  attendants  must  always  be  present  to  see  that  every 
one  has  a  proper  supply.  They  must  see  that  no  patient  carries  away 
a  knife,  fork  or  any  other  article  from  the  table.  An  attendant  must 
never  place  in  the  hands  of  a  patient,  or  leave  where  a  patient  can  get, 
any  penknife,  rope,  cord,  razor,  medicine,  matches,  or  any  dangerous 
weapon,  or  article.  A  constant  watch  of  patients  is  to  be  kept  in 
these  respects.  An  attendant  must  never  deliver  a  letter  from  or  to  a 
patient  without  permission  from  the  keeper,  nor  ever  to  retain  in  his 
or  her  possession,  without  permission,  any  writing  of  a  patient. 

12.  No  attendant  or  employee  of  the  asylum  must  absent  themselves 
without  permission  from  the  keeper,  or  his  assistant.  Application 
for  leave  of  absence  should  be  made  several  hours  before  leaving  ;  if 
such  permission  be  granted,  they  must  leave  their  keys  in  the  office 
until  their  return.   This  rule  applies  to  all  employees  in    the  asylum. 

13.  The  engineer  shall  have  charge  of  the  boiler-house,  boilers,  and 
general  charge  and  oversight  of  all  machinery  in  the  wash-house  and 
ironing  room,  the  apparatus  for  extinguishing  fires,  for  warming  and 
ventilation,  of  pipe-fittings,  sewers  ana  water  supply.  He  shall  also 
be  subject  to  the  same  rules  as  other  attendants  and'  employees. 

14.  It  shall  be  the  duties  of  the  cooks,  of  both  keeper's  and  inmates' 
kitchen,  to  see  to  the  safe-keeping  and  economical  use  of  all  the  sup- 
plies furnished  them,  that  the  food  is  well  cooked  and  nothing  wasted. 
They  shall  take  no  victuals  into  the  wards  or  other  places  in  the  asy- 
lum, or  allow  to  be  taken,  unless  so  ordered  by  superintendent,  matron 
or  physician.  They  must  see  that  their  kitchen,  store-room,  cellar, 
pantry,  and  such  other  places  which  are  under  their  charge,  are  kept 
clean.  They  are  subject  to  the  same  rules  as  other  attendants  or  em- 
ployees, and  shall  obey  orders,  which  may  be  given  to  them  from  time 
to  time,  by  the  keeper,  matron  or  physician. 

15.  It  shall  be  the  duty  of  the  attendant  that  has  charge  of  the  wash- 
house  to  see  that  all  the  clothes  are  properly  washed,  ironed  and  sent 
to  the  store-room.  Those  that  need  mending  to  be  sent  to  the  sewing- 
room,  and  see  that  no  inmate  escape  while  under  his  or  her  charge ; 
and  is  subject  to  the  same  rules  as  other  attendants  or  employees. 

EuLEs  AND  Regulations  of  the  "  Oneida  County  Insane  Asylum," 

No.  1.  The  morning  bell  shall  be  rung  at  five  o'clock.  Breakfast 
will  be  served  at  six  o'clock,  dinner  twelve  m.  ,  tea  at  six  p.  m.,  the  year 
round. 

No.  2.  The  asylum  is  to  be  closed  at  ten  o'clock  every  night,  at 
which  time  the  attendants  and  assistants  must  all  retire  to  their  apart- 
ments. 

No.  3 .  Sunday  the  buildings  and  grounds  are  not  to  be  exhibited 
to  visitors;  nor  shall  any  visitor  be  admitted  into  the  wards  or  rooms 
of  patients  or  attendants,  except  in  cases  of  serious  illness  and  by 
special  permission  of  the  superintendent. 

No.  4.  The  person  or  persons  directed  to  accompany  visitors  through 
the  wards  will  not  be  permitted  to  point  out  or  mention  the  names  or 
14 


104  Beport  on  the  Chronic  Insane. 

peculiarities  or  conduct  of  patients.  The  history,  conduct  and  con- 
versation ot  patients  must  never  be  spoken  of  to  visitors,  nor  reported 
by  attendants  when  abroad. 

No.  5.  An  attendant  or  assistant  must  not  receive  a  present  or 
gratuity  from  any  patient  in  the  asylum  or  the  friend  of  a  patient,  or 
a  visitor  ;  or  sell  to  or  buy  any  thing  from  a  patient,  or  receive  any  per- 
quisite of  any  kind  whatever. 

No.  6.  The  whole  time  of  attendants  and  assistants  belongs  to  the 
asylum.  This  does  not  prohibit  each  one  from  attending  to  his  or 
her  own  clothing. 

No.  7.  No  company  shall  be  admitted  into  the  rooms  or  wards  oc- 
cupied by  tiic  patients  at  any  time,  except  by  the  express  permission 
of  the  superintendent  or  matron.  All  persons  employed  by  the  insti- 
tution are  expected  to  show  marked  respect  and  attention  to  strangers 
and  visitors. 

No.  8.  The  attendants  and  assistants  must  never  leave  the  asylum 
without  permission  of  the  superintendent  or  matron.  Attendants 
when  thus  leaving  must  deposit  the  keys  of  the  ward  in  the  ofiBce  as 
directed,  until  their  return. 

No.  9.  Attendants  will  notice  the  habits  and  conduct  of  patients, 
and  inform  the  physician  at  his  daily  visit  of  all  circumstances  re- 
quiring attention  ;  such  as  loss  of  appetite  or  any  indisposition. 

No.  10.  Food  is  not  to  be  carried  to  the  rooms  of  patients  ;  nor  is 
any  one  to  be  absent  from  the  regular  meals,  excepting  in  cases  of 
sickness  or  high  excitement,  without  permission. 

No.  11.  The  attendants  shall  never  apply  any  restraining  apparatus 
without  giving  immediate  notice  to  superintendent  or  matron. 

No.  12.  An  attendant  must  never  place  in  the  hands  of  a  patient, 
or  leave  where  a  patient  can  get,  any  razor,  penknife,  rope,  cord, 
medicines,  matches,  or  any  dangerous  wea])on  or  article.  A  constant 
watch  of  patients  is  to  be  kept  in  these  respects,  their  beds  frequently 
searched  for  such  articles,  and  the  knives  and  forks  counted  after  each 
meal.  An  attendant  must  never  deliver  any  letter  or  writing  from  or 
to  a  patient  without  permission  of  the  superintendent;  nor  ever  retain 
in  his  or  her  possession,  without  such  permission  any  writing  of  a 
patient. 

No.  13.  One  attendant  must  always  be  on  the  seventh  and  ninth 
wards  with  the  patients,  and  must  not  leave  under  any  circumstances 
until  relieved. 

No.  14.  The  dress  of  attendants  should  always  be  neat  and  clean. 
Never  indulge  in  loud  talking  or  laughing;  use  no  profane,  obscene  or 
vulgar  language.  Never  play  at  any  games  with  one  another  nor  with 
patients. 

No.  15.  If  the  attendant  receives  insult  and  abusive  language,  he 
must  keep  cool  and  not  scold  or  threaten.  Violent  hands  are  never 
to  be  laid  on  a  patient  under  any  provocation.  A  blow  is  never  to  be 
returned,  nor  any  other  insults.  Sufficient  force  to  prevent  the  patient 
injuring  himself  or  others  is  always  to  be  applied  gently,  and  all 
struggling  with  a  patient  should,  if  possible,  be  avoided  by  calling  ad- 
ditional assistance. 

No.  16.  Male  attendants  and  employees  are  not  allowed  to  visit  the 
women's  wards  except  on  order  of  superintendent  or  matron. 

No.  17.  The  night  watchman  shall  visit  all  the    wards   every  hour 


Kepokt  on  the  Chronic  Insane.  105 

and  report  any  sick  or  noisy  patients  to  the  ward  attendant.  It  shall 
be  his  duty  to  report  any  violation  of  the  rules,  during  the  night,  to 
the  superintendent. 

Dietary  at  the  Orange  County  Insane  Asylum  from  Novem- 
ber 1  TO  March  1. 

Monday. 

Breakfast  :  Bread  and  butter,    tea  and  coffee,  oat  meal. 
Dinner  :  Bread  and  meat,  rice  pudding  and  tea,  raw  onions. 
Supper  :  Mush  and  milk. 

Tuesday. 

Breakfast :  Bread  and  butter,  tea  and  coffee,  apple  sauce. 

Dinner  :  Pork  and  baked  beans,  boiled  mush  or  rice,  bread  and  tea. 

Supper :  Eice  and  milk,  molasses  cake. 

Wednesday. 

Breakfast  :  Bread  and  butter,  tea  and  coffee,  oat  meal. 
Dinner  :  Hash  meat,  bread,  boiled  onions,  pickled  beets,  tea. 
Supjier  :  Bread  and  milk. 

TJiursday. 

Breakfast:  Bread  and  butter,  tea  and  coffee,  apple  sauce. 
Dinner:  Pork  or  beef  stew,  tea  and  boiled  rice,  bread. 
Supper :  Mush  and  milk,  ginger  snaps. 

Friday. 

Breakfast :  Bread  and  butter,  tea  and  coffee,  oat  meal. 
Dinner:  Fish,  potatoes,  rice  pudding,  bread  and  tea. 
Supper  :  Kice  and  milk. 

Saturday. 

Breakfast :  Bread  and  butter,  tea  and  coffee,  apple  sauce. 
Dinner  :  Fresh  beef  soup,  bread  and  tea,  raw  onions. 
Supper :  Mush  and  milk,  cake. 

Stmday. 

Breakfast :  Bread  and  butter,  tea  and  coffee,  oat  meal. 
Dinner :  Cold  meat,  molasses  cake,  apple  sauce,  tea  and  bread. 
Supper  :  Bread  and  milk. 

Dietary  at  the  Queens  County   Insane  Asylum. 

Sunday. 

Breakfast :  Coffee,  three-eighths  of  an  ounce  ;  chicory,  three-sixty- 
fourths  ounce;  condensed  milk,  one-half  ounce;  sugar,  one-half 
ounce  ;  water,  one  pint;  mush,  two  ounces;  molasses,  one  ounce; 
bread  —  butter,  one-half  ounce. 


106  Report  on  the  Chronic  Insane4 

Dinner  :  Pea  soup,  one  pint  ;  peas,  one  and  one-half  ounces ;  beef, 
slightly  corned,  twelve  ounces:  potatoes,  eight  ounces;  vegetables, 
four  ounces;  rice  pudding,  rice,  two  ounces  ;  milk,  eight  ounces; 
sugar,  one  ounce. 

Supper  :  Tea,  one-eighth  ounce  ;  condensed  milk,  one-half  ounce  ; 
sugar,  one-half  ounce,  domestic  cake,  one  ounce;  bread  —  butter,  one- 
half  ounce. 

Monday. 

Breakfast  :  Coffee,  one  pint ;  hash,  beef,  two  ounces  ;  potatoes 
four  ounces;  bread — butter,  one-half  ounce. 

Dinner:  Irish  stew,  beef,  twelve  ounces;  potatoes,  eight  ounces 
vegetables,  four  ounces. 

Supper:  Tea,  one  pint;  dried  fruit,  stewed,  one  ounce  ;  or,  apple 
butter,  two  ounces;  bread  —  butter, one-half  ounce. 

TiLesday. 

Breakfast:  Coffee,  one  pint;  hominy,  two  ounces;  milk,  eight 
ounces;  bread  —  butter,  one-half  ounce. 

Dinner:  Meat  pie,  beef,  twelve  ounces;  potatoes,  eight  ounces; 
vegetables,  four  ounces. 

Supper:  Tea,  one  pint;  cheese,  one  ounce;  brown  bread;  butter, 
one-half  ounce. 

Wednesday. 

Breakfast :  Coffee,  one  pint;  wheaten  grits,  two  ounces  ;  molasses, 
one  ounce;  bread  —  butter,  one-half  ounce. 

Dinner:  Vegetable  soup,  one  pint;  roast  beef,  twelve  ounces;  pota- 
toes, eight  ounces;  vegetables,  four  ounces. 

Supper:  Tea,  one  pint;  pickles,  one  ounce;  bread  —  butter,  one- 
half  ounce. 

Thursday. 

Breakfiist :  Coffee,  one  pint  ;  hash,  beef,  two  ounces ;  potatoes,  four 
ounces ;  bread  —  butter,  one-half  ounce. 

Dinner:  Mutton  stew,  mutton,  twelve  ounces;  potatoes,  eight 
ounces  ;  vegetables,  four  ounces. 

Supper:  Tea,  one  pint;  head  cheese,  one  ounce;  brown  bread; 
butter,  one-half  ounce. 

Friday. 

Breakfast:  Coffee,  one  pint ;  mush,  two  ounces  ;  syrup,  one  ounce  ; 
bread —  butter,  one-half  ounce. 

Dinner:  Salt  codfish;  five  ounces;  potatoes,  eight  ounces;  vege- 
tables, four  ounces  ;  bread  pudding,  four  ounces  :  hard  sauce,  butter, 
one-half  ounce  ;  sugar,  one-half  ounce. 

Supper:  Tea,  one  pint;  molasses  cake,  one  (unce;  bread  —  butter, 
one-  half  ounce. 


Report  on  the  Chrokic  Insane.  107 

Saturday. 

Breakfast  :  Coffee,  one  pint :  rice,  two  ounces  ;  milk,  eiglit  ounces  ; 
bread  —  butter,  one-half  ounce. 

Dinner:  Beef  soup,  one  pint;  roast  beef,  twelve  ounces;  potatoes 
eight  ounces  ;  vegetables,  four  ounces. 

Supper:  Tea,  one  pint;  dried  fruit,  stewed,  one  ounce;  or,  apple 
butter,  two  ounces;  bread  — butter,  one-half  ounce. 

Sunday. 

Breakfast  :  Coffee,  one  pint ;  oatmeal,  two  ounces ;  molasses,  one 
ounce  ;  bread  —  butter,  one-half  ounce. 

Dinner  :  Bean  soup,  beans,  one  ounce  ;  beef,  slightly  corned,  twelve 
ounces;  potatoes,  eight  ounces;  vegetables,  four  ounces. 

Supper  :  Tea,  one  pint;  smoked  iish,  one  ounce;  rye  bread;  butter 
one-half  ounce. 

Monday. 

Breakfast  :  Coffee,  one  pint  ;  hash,  beef,  two  ounces  ;  potatoes,  four 
ounces;  bread  —  butter,  one-half  ounce. 

Dinner :  Roast  mutton,  twelve  ounces ;  potatoes,  eight  ounces ; 
vegetables,  four  ounces. 

Supper  :  Tea,  one  pint;  domestic  cake,  one  ounce  ;  bread  —  butter, 
one-half  ounce. 

Tuesday. 

Breakfast:  Coffee,  one  pint;  mush,  two  ounces;  milk,  eight  ounces; 
bread  —  butter,  one-half  ounce. 

Dinner:  Beef  stew,  beef,  twelve  ounces;  potatoes,  eight  ounces; 
vegetables,  four  ounces. 

Supper ;  Tea,  one  pint ;  cheese  one  ounce  ;  brown  bread  ;  butter, 
one-half  ounce. 

Wednesday. 

Breakfast:  Coffee,  one  pint;  hash,  beef,  two  ounces;  potatoes,  four 
ounces  ;  bread  —  batter,  one-half  ounce. 

Dinner:  Barley  soup,  barley,  one  ounce;  baked  pork,  four  ounces; 
beans,  three  ounces ;  beets,  pickled,  four  ounces  ;  vegetables,  four 
ounces  ;  hominy,  two  ounces;  molasses,  one-half  ounce. 

Supper:  Tea,  one  pint;  pickles,  one  ounce;  bread  —  butter,  one- 
half  ounce. 

Thursday. 

Breakfast:  Coffee,  one  pint;  rice,  two  ounces;  sugar  sauce,  sugar, 
one-half  ounce;  bread  —  butter,  one-half  ounce. 

Dinner  :  Macaroni  soup,  macaroni,  one-eighth  ounce  ;  roast  beef, 
twelve  ounces  ;  potatoes,  eight  ounces  ;  vegetables,  four  ounces. 

Supper  :  Tea,  one  pint;  dried  fruit,  stewed,  one  ounce;  or,  apple 
butter,  two  ounces  ;  brown  bread  ;  butter,  one-half  ounce. 


108  Report  on  the  Chronic  Insane. 

Friday. 

Breakfast:  Coffee,  one  pint;  hominy,  two  ounces;  syrup,  one 
ounce;  bread  —  butter,  one-half  ounce. 

Dinner:  Fresh  fish,  eight  ounces;  potatoes,  eight  ounces;  vege- 
tables, four  ounces;  bread  pudding,  four  ounces;  hard  sauce,  butter, 
one-half  ounce  ;  sugar,  one-half  ounce. 

Supper:  Tea,  one  pint;  molasses  cake,  one  ounce  ;  bread  —  butter, 
oue-half  ounce. 

Sat^irday. 

Breakfast:  Coffee,  one  pint;  oatmeal,  two  ounces;  milk,  eight 
ounces;  bread  —  butter,  one-half  ounce. 

Dinner :  Mutton  pot  pie,  mutton,  twelve  ounces;  potatoes,  eight 
ounces ;  vegetables,  four  ounces. 

Supper:  Tea,  one  pint;  head  cheese,  one  ounce;  rye  bread  ;  butter, 
one-half  ounce. 

First.  Bread  is  allowed  ad  libitum.  Second.  The  bone  is  included 
in  the  meat  ration  of  twelve  ounces.  Third.  Cabbage,  carrots,  pars- 
nips, leeks,  onions,  tomatoes,  beets,  etc.,  are  furnished  as  vegetables. 
Fourth.  Diet  for  the  sick :  milk,  beef,  tea,  eggs,  cocoa,  sago,  farina, 
rice,  chickens  and  oysters  are  furnished  for  the  sick  on  the  order  of 
the  medical  superintendent.  Fifth.  Sauce  for  the  fish  ;  flour,  fifteen 
pounds;  condensed  milk,  three  quarts;  butter,  six  pounds  (this 
quantity  is  for  one  thousand  persons).  The  dietary  scale  covers  a 
period  of  two  weeks  for  the  purpose  of  affording  greater  variety  than 
a  weekly  scale. 


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